Table 1 Demographic characteristics of the included studies

1

Singhal et al., [22]

NSAID

Prednisolone 1%

preservative-free ketorolac (0.4%), bromfenac (0.07%), nepafenac (0.3%), topical nepafenac (0.1%)

Topical drops

379

91

All grades of cataract

NR

65.4

271

199

1 and 6 weeks after surgery.

NR

2

Wang et al., [19]

NSAID

Dexamethasone 0.1%

bromfenac sodium 0.1%

Topical drops

116

41

NR

46–92 years,

Nebafenac 73.37 ± 9.17)

111

129

Baseline, day 1, week 1, 1 month, 2 months

3

Stock et al., [9]

NSAID

Propylene glycol

0.3% nepafenac, 0.5% ketorolac tromethamine

Topical drops

53

24

NR

NR

NR

1, 7, and 45 days postoperatively

NR

4

Campa et al., [12]

NSAID + dexamethasone

Dexamethasone

Nepafenac + Dexa, Bromfenac + Dexa

Topical drops

96

48

senile cataract except extremely dense cataracts

nepafenac: 77 ± 5.93, bromfenac: 78.21 ± 7.87

43

53

Baseline, week 1, week 5

Baseline, week 1, week 5

NR

5

Wielders et al., [13]

NSAID

Dexamethasone 0.1%

bromfenac 0.09%, Brom + DEXA

Topical drops

307

Control group 1: 304

Control group 2: 303

Nuclear, Cortical, Subcapsular

bromfenac: 69.70 ± 8.94, brom + dexa: 70.41 ± 8.91

71.23 ± 8.73

NR

NR

Baseline, week 6, week 12

Baseline, week 6, week 12

Cystoid macular edema was defined as an increase in central subfield mean macular thickness of 10% or more over baseline, CSME was defined as CME with less than a 0.2 logMAR CDVA improvement compared with the preoperative baseline. withcysticchangesonSD-OCT.

6

Mathys et al., [15]

NSAID + dexamethasone

Dexamethasone

nepafenac 0.1%

Topical drops

39

40

NS, PSCC, CC

73.95

70.33

37

42

1 day

1 week

1 month,

2 months

1 day

1 week

month,

2 months

an average increase in foveal thickness of 10–22 (+/- 24) microns occurs after an uncomplicated phacoemulsification, an increase in CMT by 40 microns or more on OCT was considered to be significant and taken as a criterion for analysis.[21] Clinical CME was defined as a significant increase in CMT along with visible cystic changes and final BCVA less than 6/9.

7

Tzelikis et al., [18]

NSAID

Placebo

nepafenac 0.3%

Topical drops

103

103

Nuclear opalescence

68.32 + 9.08

68.32 + 9.08

39

73

1 week,

5 weeks,

12 weeks.

1 week,

5 weeks,

12 weeks.

Clinically significant macular edema, which consists of the presence of macular edema associated with reduced visual acuity, It is thought to be caused by the release of inflammatory mediators such as prostaglandins and leukotrienes during cataract sur- gery, which can lead to an increase in vascular permeability in the blood–retinal barrier with subsequent accumulation of fluid in the macula.

8

Zaczek et al., [27]

NSAID + dexamethasone

Dexamethasone 0.1%

nepafenac 0.1% and dexamethasone 0.1%.

Topical drops

75

77

NR

70.4 ± 7.4

68.3 ± 7.5

54

98

1 day, 3 weeks, and 6 weeks

1 day, 3 weeks, and 6 weeks

an accumulation of extracellular intraretinal fluid in the outer plex- iform and in the inner nuclear layers of the retina resulting from a breakdown of the blood–retinal barrier in response to a postoperative inflammation in the anterior chamber.

9

Erichsen et al., [14]

NSAID + prednisolone

Pre-treatment

ketorolac tromethamine, 0.5%

Topical drops

94

94

NR

G1: 72.3. G2: 71.8. G3: 72.2. G4: 71.8

72.6

180

290

at the preoperative visit (baseline) and 3 days, 3 weeks, and 3 months postoperatively

at the preoperative visit (baseline) and 3 days, 3 weeks, and 3 months postoperatively

PCME is caused by the in- flammatory response after cataract surgery, which disrupts the blood-ocular barrier leading to leakage of fluid into the retina.4

10

Donnenfeld et al., [13]

NSAID

Placebo

ketorolac tromethamine 0.4%

Topical drops

75

25

NR

72.8 ± 8.5

72.8 ± 8.5

NR

NR

1 day, 2 weeks, and 3 months

1 day, 2 weeks, and 3 months

Cystoid macular edema, a cystic accumulation of extracellular intraretinal fluid in the outer plexiform and inner nuclear layers of the retina, is a result of breakdown of the blood–retinal barrier.

11

Yavas et al., [21]

NSAID

topical steroids and antibiotics

indomethacin 0.1%.

Topical drops

121

58

NR

Group1: 65.28 ± 9.90. Group2: 62.25 ± 11.57

64.78 ± 9.18

106

73

3 moths post-op

3 months post-op

Cystoid macular edema is related to the disruption of the blood–retinal barrier and blood–aqueous barrier (BAB) and the inflammation induced by prostaglandins or other inflammatory mediators.

12

Almeida et al., [11]

NSAID

Placebo

Ketorolac 5%, Nepafenac 5%

eye drops

108

54

NR

2.4 ± 8.2

74

88

At day 0 or 1, at 1 month

At day 0 or 1, at 1 month

NR

13

Ticly et al., [17]

NSAID

Placebo

NR

eye drops

37

44

Nuclear cataract density of 2&3

67.1+/-10.8

66.1 ± 8.7

43

38

Patients were evaluated at 1 day and 5 weeks postoperatively.

Patients were evaluated at 1 day and 5 weeks postoperatively.

Was defined as the presence of well-defined cystic fluid pockets, which presented as hyporeflective lacunae with well-defined boundaries observed in the retina layers17 or a CSF thickness above 315 mm

14

Miyake et al., [16]

NSAID

Dexamethasone 0.1%

Diclofenac 0.1%, fluorometholone 0.1%

eye drops

25

25

Senile

65.4+/-7.0

65.8 ± 7.1

23

27

At2 days, 1 week, 2 weeks,5 weeks

At2 days, 1 week, 2 weeks,5 weeks

captured by fluorescein angiography at 2 and 5 weeks after surgery. It was garded as followes: 0 = no dye accumulation or leakage. 1 = slight dye accumulation at the cystic space & incompletely surrounding the fovea. 2 = dye accumulation surrounding the fovea & a diameter of less than 2 mm. 3 = dye accumulation surrounding the fovea & a diameter greater than 2 mm.

15

Jung et al., [26]

NSAID

Steroid

Bromofenac 0.1%, Ketorolac 0.45%

eye drops

60

31

NR

(G1: 66.9+/-11.1. G2: 67.5+/-7.0. age (range)(year)

66.8 ± 8.1

41

50

Post-op day 1, 7, 28.

Post-op day 1, 7, 28.

CME was defines as prescenec of cystoid changes associated with substantial (> 40 μm) retinal thickness.

16

Howaidy et al., [24]

NSAID

Placebo

Nepafenac: 0.1%

Ophthalmic solution

38

41

cataract density G II or III determined by LOCS III classification

63.1 ± 3.9 (57–69)

62.5 ± 5.3 (51–72)

42

37

1 week, 1 month, and 3 months after surgery

1 week, 1 month, and 3 months after surgery

NR

17

Ibrahim et al., [25]

NSAID + dexamethasone

Dexamethasone 0.1%

Nepafenac: 0.1%

eye drops

36

18

Senile

60.83 ± 4.06 years

60.83 ± 4.06 years

NR

NR

day 1, 1 week and 1 month

day 1, 1 week and 1 month

NR

18

Moschos et al., [23]

NSAID + dexamethasone

Dexamethasone

chloramphenicol 0.5%/dexamethasone sodium phosphate 0.1%/ diclofenac sodium 0.1%

Topical

38

41

NR

76.68 ± 10.72

76.71 ± 8.82

27

52

postoperative days 1, 14, and 28

NR