Уважаемые коллеги! Есть и другие данные по сравнительной эффективности стероидов и нестероидных препаратов.
Ophthalmology
Volume 121, Issue 10, October 2014, Pages 1915–1924
Post-cataract Prevention of Inflammation and Macular Edema by Steroid and Nonsteroidal Anti-inflammatory Eye Drops : A Systematic Review
Line Kessel, MD, PhD1, 2, , , Britta Tendal, PhD2, Karsten Juhl Jørgensen, MD, DrMedSci2, 3, Ditte Erngaard, MD4, Per Flesner, MD, PhD5, Jens Lundgaard Andresen, MD, PhD6, Jesper Hjortdal, MD, DrMedSci7
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Favorable outcome after cataract surgery depends on proper control of the inflammatory response induced by cataract surgery. Pseudophakic cystoid macular edema is an important cause of visual decline after uncomplicated cataract surgery.
Design
We compared the efficacy of topical steroids with topical nonsteroidal anti-inflammatory drugs (NSAIDs) in controlling inflammation and preventing pseudophakic cystoid macular edema (PCME) after uncomplicated cataract surgery.
Participants
Patients undergoing uncomplicated surgery for age-related cataract.
Methods
We performed a systematic literature search in Medline, CINAHL, Cochrane, and EMBASE databases to identify randomized trials published from 1996 onward comparing topical steroids with topical NSAIDs in controlling inflammation and preventing PCME in patients undergoing phacoemulsification with posterior chamber intraocular lens implantation for age-related cataract.
Main Outcome Measures
Postoperative inflammation and pseudophakic cystoid macular edema.
Results
Fifteen randomized trials were identified. Postoperative inflammation was less in patients randomized to NSAIDs. The prevalence of PCME was significantly higher in the steroid group than in the NSAID group: 3.8% versus 25.3% of patients, risk ratio 5.35 (95% confidence interval, 2.94–9.76). There was no statistically significant difference in the number of adverse events in the 2 treatment groups.
Conclusions
We found low to moderate quality of evidence that topical NSAIDs are more effective in controlling postoperative inflammation after cataract surgery. We found high-quality evidence that topical NSAIDs are more effective than topical steroids in preventing PCME. The use of topical NSAIDs was not associated with an increased events. We recommend using topical NSAIDs to prevent inflammation and PCME after routine cataract surgery.
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