How to Prevent Cystoid Macular Edema after Cataract Surgery?

Cystoid macular edema (CME) continues to be an important complication after cataract surgery and other ophthalmological interventions. Indeed, this collateral effect represents the main cause of decreased visual acuity after phacoemulsification, even in uneventful surgeries and in patients without additional risks factors [1]. Although the frequency of clinically significant CME may vary from 0.1% to 3% among patients without risk factors, some clinical trials reported up to 9% of increased mean foveal thickness, as measured by Optical Coherence Tomography (OCT) and Angiographic macular edema [1,2]. Surgical complications like posterior capsule rupture with vitreous loss and retained lens material, as well as systemic comorbidities with high vasoactive profile (diabetic retinopathy, uveitis) may increase the incidence of clinically significant CME up to 20%.2 Albeit both steroids and non-steroidal anti-inflammatory drugs (NSAIDs) have been proposed to treat and prevent the occurrence of CME after phacoemulsification, their actual benefit remains to be fully elucidated. Therefore, an effective strategy to prevent CME after phacoemulsification with IOL implantation is required.