Topical steroid and NSAID combo provides optimal CME prophylaxis-PREMED study

The first report from the ESCRS PREMED study has provided evidence supporting the use of a combination of topical corticosteroid and a topical nonsteroidal anti-inflammatory drug (NSAID) to prevent cystoid macular oedema (CME) after cataract surgery in nondiabetic patients.

The study comprised 914 patients randomised to receive topical bromfenac 0.09% twice daily for two weeks, a tapering dose of dexamethasone 0.1%, or a combination of both. The study showed that at six weeks postoperatively, patients in the bromfenac and dexamethasone group had significantly greater reductions in macular thickness than the other two groups.

In addition, the incidence of clinically significant CME during the first 12 weeks postoperatively was only 1.5% in the combination group compared to 5.1% in the dexamethasone monotherapy group.


LHP Wielders et al, “European multicenter trial of the prevention of cystoid macular edema after cataract surgery in nondiabetics: ESCRS PREMED study report 1”, J Cataract Refract Surg 2016, 44;4: 429–439.

Source: JCRS

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