PMID- 38007198
OWN - NLM
STAT- MEDLINE
DCOM- 20240422
LR  - 20240422
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 131
IP  - 5
DP  - 2024 May
TI  - The Efficacy and Safety of Standard versus Soft Topical Steroids after Cataract 
      Surgery: A Systematic Review and Meta-analysis.
PG  - 595-610
LID - S0161-6420(23)00857-6 [pii]
LID - 10.1016/j.ophtha.2023.11.022 [doi]
AB  - TOPIC: Review of the efficacy and safety of standard versus soft topical steroid 
      application after cataract surgery. CLINICAL RELEVANCE: The control of 
      postoperative inflammation is the mainstay of treatment after cataract surgery. 
      However, no consensus exists regarding the postoperative steroid of choice. 
      Basing the choice of topical postoperative steroidal treatment on high-quality 
      data regarding both risks and benefits of various drugs would be advantageous for 
      both patients and clinicians. METHODS: A systematic search of the PubMed, Scopus, 
      and Embase electronic databases for all peer-reviewed published randomized 
      control trials that included clinical outcomes of topical steroidal treatment 
      after uneventful cataract surgery was performed. Individual study data were 
      extracted and evaluated in a weighted pooled analysis including grading of total 
      anterior chamber (AC) inflammation, AC cells, AC flare, postoperative visual 
      acuity (VA), intraocular pressure (IOP), and rate of adverse events (AEs). 
      RESULTS: Overall, 508 studies were found, of which 7 were eligible for the 
      systematic review and ultimately were included for analysis, reporting on 593 
      patients from 5 countries. Age of included patients, when available, ranged 
      between 3.7 and 73.4 years. Follow-up data were available for analysis at 1, 7, 
      and 28 days after surgery. Except for a significantly lower grade of AC flare in 
      the standard steroid group at day 7 (standardized mean difference, 0.26; 95% 
      confidence interval, 0.05-0.47; I(2) = 0%), inflammatory activity measurements 
      displayed insignificant differences at every other follow-up (days 1 and 28 after 
      surgery). Pooled analysis of IOP at each follow-up demonstrated a higher IOP at 
      the 7-day visit in the standard steroid group, whereas IOP at other time points 
      was comparable among the groups. Qualitative analysis of ocular AEs showed 
      similarities among the groups. DISCUSSION: The findings of this study suggest 
      that for the average patient, both groups produce a comparable effect on both AC 
      inflammation and postoperative IOP and VA. FINANCIAL DISCLOSURE(S): The author(s) 
      have no proprietary or commercial interest in any materials discussed in this 
      article.
CI  - Copyright (c) 2023 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Noyman, Dror Ben Ephraim
AU  - Noyman DBE
AD  - Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
FAU - Chan, Clara C
AU  - Chan CC
AD  - Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, 
      Ontario, Canada.
FAU - Mimouni, Michael
AU  - Mimouni M
AD  - Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; Bruce and 
      Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 
      Haifa, Israel.
FAU - Safir, Margarita
AU  - Safir M
AD  - Department of Ophthalmology, Yitzhak Shamir Medical Center, Sackler Faculty of 
      Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: 
      safir.margarita@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20231123
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
RN  - 0 (Steroids)
SB  - IM
MH  - Humans
MH  - Child, Preschool
MH  - Child
MH  - Adolescent
MH  - Young Adult
MH  - Adult
MH  - Middle Aged
MH  - Aged
MH  - *Cataract Extraction/adverse effects
MH  - *Glaucoma/surgery
MH  - Steroids
MH  - Inflammation/etiology
MH  - *Cataract/etiology
OTO - NOTNLM
OT  - Cataract surgery
OT  - Soft steroids
OT  - Topical steroids
EDAT- 2023/11/26 07:44
MHDA- 2024/04/22 06:42
CRDT- 2023/11/25 19:31
PHST- 2023/07/02 00:00 [received]
PHST- 2023/10/27 00:00 [revised]
PHST- 2023/11/17 00:00 [accepted]
PHST- 2024/04/22 06:42 [medline]
PHST- 2023/11/26 07:44 [pubmed]
PHST- 2023/11/25 19:31 [entrez]
AID - S0161-6420(23)00857-6 [pii]
AID - 10.1016/j.ophtha.2023.11.022 [doi]
PST - ppublish
SO  - Ophthalmology. 2024 May;131(5):595-610. doi: 10.1016/j.ophtha.2023.11.022. Epub 
      2023 Nov 23.