Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysis
AIM: To assess and rank the efficacy of various non-steroidal anti-inflammatory drugs (NSAIDs) in preventing postoperative macular edema (PME) after cataract surgery. METHODS: A comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Web of Science databases. Randomized contr...
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Press of International Journal of Ophthalmology (IJO PRESS)
2025-09-01
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| Series: | International Journal of Ophthalmology |
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| Online Access: | http://ies.ijo.cn/en_publish/2025/9/20250915.pdf |
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| author | Min Lang Jie Xuan Xue Li Ming-Ming Liu Jie Xu Ting Liu |
| author_facet | Min Lang Jie Xuan Xue Li Ming-Ming Liu Jie Xu Ting Liu |
| author_sort | Min Lang |
| collection | DOAJ |
| description | AIM: To assess and rank the efficacy of various non-steroidal anti-inflammatory drugs (NSAIDs) in preventing postoperative macular edema (PME) after cataract surgery. METHODS: A comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Web of Science databases. Randomized controlled trials (RCTs) comparing different NSAIDs and control treatments for the prevention of PME were included. Data from the studies were synthesized using the “gemtc” package in R. Risk of bias was assessed with the Cochrane RoB 2 tool, and heterogeneity was evaluated using the global I2 statistic. Surface under the cumulative ranking curve (SUCRA) values were calculated for each treatment. RESULTS: Of 132 identified records, 9 RCTs met the inclusion criteria. The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME, followed by artificial tear substitute, ketorolac, diclofenac, and bromfenac. The league table comparisons and rankograms corroborated these findings, with nepafenac consistently ranking highest. Heterogeneity analysis yielded high I2 values, indicating substantial variability across studies. CONCLUSION: This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery. Given the substantial heterogeneity observed, further high-quality RCTs are required to confirm these findings and explore the sources of variability. Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients. |
| format | Article |
| id | doaj-art-7e93519ba0e04eb3a771f3e949ef0693 |
| institution | Kabale University |
| issn | 2222-3959 2227-4898 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Press of International Journal of Ophthalmology (IJO PRESS) |
| record_format | Article |
| series | International Journal of Ophthalmology |
| spelling | doaj-art-7e93519ba0e04eb3a771f3e949ef06932025-08-22T06:07:08ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982025-09-011891730173610.18240/ijo.2025.09.1520250915Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysisMin Lang0Jie Xuan1Xue Li2Ming-Ming Liu3Jie Xu4Ting Liu5Ting Liu and Min Lang. Department of Ophthalmology, Daping Hospital, Army Medical University, Chongqing 200031, China. tingliu1597@126.com; langmin2012@tmmu.edu.cnDepartment of Ophthalmology, Daping Hospital, Army Medical University, Chongqing 200031, ChinaDepartment of Ophthalmology, Daping Hospital, Army Medical University, Chongqing 200031, ChinaDepartment of Ophthalmology, Daping Hospital, Army Medical University, Chongqing 200031, ChinaDepartment of Ophthalmology, Daping Hospital, Army Medical University, Chongqing 200031, ChinaDepartment of Ophthalmology, Daping Hospital, Army Medical University, Chongqing 200031, ChinaAIM: To assess and rank the efficacy of various non-steroidal anti-inflammatory drugs (NSAIDs) in preventing postoperative macular edema (PME) after cataract surgery. METHODS: A comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Web of Science databases. Randomized controlled trials (RCTs) comparing different NSAIDs and control treatments for the prevention of PME were included. Data from the studies were synthesized using the “gemtc” package in R. Risk of bias was assessed with the Cochrane RoB 2 tool, and heterogeneity was evaluated using the global I2 statistic. Surface under the cumulative ranking curve (SUCRA) values were calculated for each treatment. RESULTS: Of 132 identified records, 9 RCTs met the inclusion criteria. The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME, followed by artificial tear substitute, ketorolac, diclofenac, and bromfenac. The league table comparisons and rankograms corroborated these findings, with nepafenac consistently ranking highest. Heterogeneity analysis yielded high I2 values, indicating substantial variability across studies. CONCLUSION: This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery. Given the substantial heterogeneity observed, further high-quality RCTs are required to confirm these findings and explore the sources of variability. Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.http://ies.ijo.cn/en_publish/2025/9/20250915.pdfpostoperative macular edemacataract surgerynon-steroidal anti-inflammatory drugsnetwork meta-analysisnepafenac |
| spellingShingle | Min Lang Jie Xuan Xue Li Ming-Ming Liu Jie Xu Ting Liu Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysis International Journal of Ophthalmology postoperative macular edema cataract surgery non-steroidal anti-inflammatory drugs network meta-analysis nepafenac |
| title | Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysis |
| title_full | Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysis |
| title_fullStr | Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysis |
| title_full_unstemmed | Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysis |
| title_short | Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysis |
| title_sort | comparative efficacy of non steroidal anti inflammatory drugs in preventing postoperative macular edema following cataract surgery a systematic review and network meta analysis |
| topic | postoperative macular edema cataract surgery non-steroidal anti-inflammatory drugs network meta-analysis nepafenac |
| url | http://ies.ijo.cn/en_publish/2025/9/20250915.pdf |
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