Topical non-steroidal anti-inflammatory drugs (NSAIDs) are a well-established component of postoperative cataract surgery management. They act by inhibiting cyclooxygenase (COX) enzymes and thereby reducing prostaglandin synthesis, which is the primary mediator of the inflammatory cascade following intraocular surgery. ¹
The primary clinical rationale for NSAID use after cataract surgery is the prevention of cystoid macular oedema (CMO). Systematic review evidence, including Cochrane-level analyses, supports the efficacy of topical NSAIDs in reducing the incidence of clinically significant CMO compared with steroid monotherapy, particularly in non-diabetic patients. ²
In practice, Blue Fin Vision® uses combination postoperative drops: a topical corticosteroid to manage anterior segment inflammation and a topical NSAID to reduce the risk of posterior segment CMO. Both are typically prescribed for four to six weeks following surgery, with the specific protocol adjusted for patients with elevated CMO risk.
The use of combination therapy rather than steroid monotherapy reflects current best-practice consensus and is consistent with published NICE guidance and Royal College of Ophthalmologists recommendations. ³
Patients should be aware that the postoperative drop protocol is clinically meaningful, not merely precautionary. Adherence to the prescribed schedule is an important contributor to optimal visual outcomes and should be maintained even when the eye feels comfortable.
The postoperative pharmacological protocol is as important as the surgery itself in determining final visual outcomes. NSAID compliance is not optional.
References
- Flach AJ. Cyclo-oxygenase inhibitors in ophthalmology. Surv Ophthalmol. 1992;36(4):259–284.
- Wielders LHP, et al. Prevention of CME after cataract surgery. J Cataract Refract Surg. 2018;44(4):429–454.
- NICE. Cataracts in adults: management. NICE guideline NG77. London: NICE; 2017.
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