ReviewClinical ophthalmology (Auckland, N.Z.)2017
Topical nepafenac for prevention of post-cataract surgery macular edema in diabetic patients: patient selection and perspectives.
Review in Clinical ophthalmology (Auckland, N.Z.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Cataract surgery in diabetes mellitus: A systematic review.Indian journal of ophthalmology · 2018Pooled it
- The effects of topical nepafenac on pupillary dynamics in early postoperative period following uneventful cataract surgery: a prospective randomized study.International ophthalmology · 2025Trial
- Comparison between 0.1% Nepafenac and 1% Prednisolone Eye Drop in Postoperative Management Following Micro-incisional Cataract Surgery.Korean journal of ophthalmology : KJO · 2021Trial
- Safety and efficacy of keratorefractive surgery in diabetes mellitus: A clinical review.World journal of clinical cases · 2026Review
- Novel pyrrolo[2,1-RSC advances · 2025Article
- Efficacy and Safety of Femtosecond Laser-Assisted Cataract Surgery with the Catalys Platform in Patients with Type 2 Diabetes and Cataract: A Prospective Cohort Study.Ophthalmology and therapy · 2025Article
- Cataract surgery and the risk of developing recurrence or progression of diabetic macular edema.PloS one · 2025Article
- Optimizing treatment for diabetic macular edema during cataract surgery.Frontiers in endocrinology · 2023Review
- Incidence of Pseudophakic Cystoid Macular Oedema Post-Cataract Surgery in Illawarra Shoalhaven Local Health District, Australia.Biomedicine hub · 2022Article
- Cataract Surgery Considerations for Diabetic Patients.Current diabetes reports · 2021Review
- Cellular targets in diabetic retinopathy therapy.World journal of diabetes · 2021Review
- Bilateral fingolimod-associated macular oedema development after cataract surgery.BMJ case reports · 2021Article
- Role of Cold Balanced Salt Solution (BSS) in the Prophylaxis of Cystoid Macular Edema After Cataract Surgery: A Prospective Randomized Study.Clinical ophthalmology (Auckland, N.Z.) · 2021Article
- Efficacy of Topical Nepafenac 0.3% in the Management of Postoperative Cystoid Macular Edema.Therapeutics and clinical risk management · 2020Article
- Cataract in diabetes mellitus.World journal of diabetes · 2019Review
- Functional and anatomical evaluation of the effect of nepafenac in prevention of macular edema after phacoemulsification in diabetic patients.International journal of ophthalmology · 2019Article
- Comparison of macular thickness by optical coherence tomography measurements after uneventful phacoemulsification using ketorolac tromethamine, nepafenac, vs a control group, preoperatively and postoperatively.Clinical ophthalmology (Auckland, N.Z.) · 2018Article
- Purtscher's-like retinopathy as a rare complication of acute alcoholic pancreatitis.Przeglad gastroenterologicznyArticle
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Since its first description, the prevention of pseudophakic cystoid macular edema (PCME) continues to pose challenges for ophthalmologists. Recent evidence suggests that prophylaxis is unnecessary in patients without risk factors. Diabetes mellitus is generally considered as a risk factor for the development of PCME after cataract surgery since it causes breakdown of the blood-retinal barrier. Diabetic retinopathy (DR) increases the risk even further. Therefore, prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs) should be considered in diabetic patients, especially if they have DR. NSAIDs block the cyclooxygenase enzymes responsible for prostaglandin production and reduce the incidence of PCME after cataract surgery. Nepafenac seems superior to other NSAIDs in terms of ocular penetration allowing higher and sustained therapeutic levels in retina and choroid. Topical steroids are less effective and may cause intraocular pressure increase limiting their long-term use. Nepafenac is cost effective, when the burden of PCME prevention is compared with the burden of treatment. Prevention is much cheaper and less harmful than invasive treatments like periocular or intravitreal injections. Overall, both nepafenac 0.1% and nepafenac 0.3% are well tolerated. They should be used carefully in patients with compromised corneas such as those with severe dry eye or penetrating grafts. If otherwise healthy cataract patients have ≥2 risk factors, like PCME in the other eye or posterior capsule rupture during surgery, treatment should be considered. Once-daily nepafenac 0.3% dosing may improve postoperative outcomes through increased patient compliance and may reduce treatment burden further. Every patient should be assessed in terms of risks/benefits of the treatment, in individual basis, before cataract surgery.
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