Abstract

Fluid accumulation in the macula as a result of inflammatory responses is a frequent postoperative complication that occurs after cataract surgery. This condition is known as pseudophakic cystoid macular edema (PCME). The pathophysiology entails the production of pro-inflammatory mediators, such as prostaglandins, increased vascular permeability, and disruption of the blood-retinal barrier. By inhibiting cyclooxygenase (COX) enzymes and reducing prostaglandin synthesis, nonsteroidal anti-inflammatory drugs (NSAIDs) are essential for the prophylaxis and treatment of PCME. Ketorolac, bromfenac, nepafenac, and diclofenac are among the topical NSAIDs that are effective in the prevention and management of PCME, particularly when used in conjunction with corticosteroids. Comparative studies indicated that NSAIDs are effective in reducing the incidence and severity of macular edema, while corticosteroids provide robust anti-inflammatory effects. Additionally, NSAIDs have favorable safety profiles. Novel formulations, combination regimens, and targeted molecular approaches are the primary focus of emerging therapies, which are tailored to the clinical presentation and patient risk factors. Treatment protocols, therefore, vary. Even though the use of NSAIDs is currently supported by guidelines, additional research is required to standardize treatment protocols and improve patient outcomes. This narrative review investigated the pathophysiology, clinical management, and evolving function of NSAIDs in PCME therapy.

Key words: Treatment, pseudophakic cystoid macular edema, NSAIDs, narrative review