EyeWorld Asia-Pacific June 2017 Issue

June 2017 34 EWAP SECONDARY FEATURE eye. Topical application achieves much higher levels of drug in the aqueous.” “There are no good data comparing oral to topical NSAIDs for the treatment or prophylaxis of CME,” Dr. Dunn said. “Until such data prove that oral NSAIDs are more effective, it seems prudent to avoid their systemic risks, especially if the patient is also taking oral corticosteroids, as is frequently the case in patients with uveitic cataracts.” “Oral NSAIDs don’t have a big role, but there’s a cadre of patients who respond well to them for a variety of conditions, including existing rheumatoid arthritis as well as scleritis or episcleritis. These patients do well on a mix of immunosuppressants and oral nonsteroidals. I’ll maintain the patient on the oral nonsteroidals if there are no other risk factors for bleeding during surgery,” Dr. Sheppard said. EWAP References 1. Kim SJ, et al. Topical nonsteroidal anti- inflammatory drugs and cataract surgery: A report by the American Academy of Ophthal- mology. Ophthalmology . 2015;122:2159–68. 2. Lim BX, et al. Prophylactic non-steroidal anti-inflammatory drugs for the prevention of macular oedema after cataract surgery. Cochrane Database Syst Rev . 2016 Nov 1;11:CD006683. 3. Kessel L, et al. Post-cataract preven- tion of inflammation and macular edema by steroid and nonsteroidal anti-inflam- matory eye drops: a systematic review. Ophthalmology . 2014;121:1915–24. 4. Duan P, et al. The comparative efficacy and safety of topical non-steroidal anti-inflam- matory drugs for the treatment of anterior chamber inflammation after cataract surgery: a systematic review and network meta-anal- ysis. Graefes Arch Clin Exp Ophthalmol . 2017 Jan 27 [epub ahead of print]. Editors’ note: [[Dr. Dunn...Dr. Kessel…]] Dr. Sheppard has financial interests with Alcon (Fort Worth, Texas), Allergan (Irvine, California), Bausch + Lomb (Bridgewater, New Jersey), and other ophthalmic companies. The other physicians interviewed have no financial interests related to their comments. Dr. Kim and Dr. Myers declared no relevant financial interests. Contact information Dunn: jpdunn@jhmi.edu Kessel: line.kessel.01@regionh.dk Kim: skim30@gmail.com Myers: wmyers2020@gmail.com Sheppard: jsheppard@vec2020.com Weighing – from page 33