Assassment of Efficacy of Non-Steroidal Anti-inflammatory Drugs in the prevention of Pseudophakic Cystoid Macular Edema in Diabetic Patients

Abstract

Macular edema is a common, final pathway for many different ocular and systemic diseases especially diabetic retinopathy (DR), retinal vascular disorders (such as central and branch retinal vein occlusion), and uveitis. Cystoid macular edema (CME) is a serious consequence of cataract surgery and other ocular procedures, resulting sometimes in transient or even permanent visual loss. CME following cataract surgery was initially reported by Irvine in 1953 and is known as the Irvine–Gass syndrome. Pseudophakic cystoid macular edema (PCME) remains the most common cause of poor visual outcome following cataract surgery The incidence of PCME ranges from 4% to 11% with optical coherence tomography (OCT) after uneventful phacoemulsification cataract surgery and peaks at approximately 4 to 6 weeks The pathologic process varies from transudation, exudation to liquefaction necrosis. The disruption of the blood-retinal barrier and micro-infarction play important roles in the formation of the macular cysts. CME is diagnosed more easily either with fluorescein angiography imaging of macular fluorescein leakage and accumulation in the macula or OCT imaging showing the macular thickness.

Many studies have shown an association between CME and inflammation,so Non-steroidal anti-inflammatory drug (NSAID) eye drops are widely used to prevent and treat ocular inflammatory conditions such as pseudophakic cystoid macular edema and are routinely used for their analgesic, antipyretic, and anti-inflammatory properties. Many studies analyzed the effects of NSAID’s on postoperative inflammation and their effect in the prevention and treatment of CME. In present study we examined 20 eye of diabetic patients underwent cataract surgery in two groups (I&II) from ophthalmic department, Eledmrdash Hospital. All patients were subjected to careful history taking, full ophthalmic examination (including visual acuity, slit lamp examination, applanation tonometry and fundus examination) and ophthalmic investigations (OCT) pre-operative and post-operative.