Effect of Perioperative Drop Regimen on CME After Cataract Surgery
Narrative Responses:
Purpose
The purpose of this paper is to determine which peri-operative drop regiment has the lowest rate of cystoid macular edema (CME).
Methods
Five year retrospective analysis with over 5000 cataract surgeries performed among 3 surgeons using 4 different regimens. All OCT were examined during this time period with analysis for CME. Positive OCTs were linked to the specific surgeon and their drop regiment to determine a clinically significant CME rate. The four drop regimens include generic steroid and NSAID, name brand steroid and NSAID (ketorolac), name brand steroid and NSAID (bromfenac) and name brand Bromfenac alone (no steroid).
Results
The highest CME rate was 2.2% (n = 725) and was seen in the all generic regimen. The lowest CME rate was 0.09% (n = 1090) and was seen in the name brand bromfenac alone group. The other groups were 0.90% (n = 2437) and 0.44% (n = 1128), that included name brand steroid and NSAID (ketorolac, bromfenac respectively). There was a statistically significant p value (0.0001) between the generic drugs and bromfenac alone group. Bromfenac alone was also better than name brand steroid and name brand ketorolac (p value = 0.005), however ketorolac was not used in every case.
Conclusion
Name brand bromfenac alone did as well or better at preventing CME than all other drop regimens used in over 5000 cases analyzed during the 5 year investigation. It especially was superior when compared to generic drugs, and when compared to name brand ketorolac.