Optimizing anti-inflammatory prophylaxis in cataract surgery: PhD thesis

Cataract is the principal cause of moderate to severe visual impairment in people older than 70 years of age and cataract surgery is the only curative treatment. To secure an excellent outcome after surgery, as expected by surgeons and patients, the postoperative inflammatory response must be controlled, and anti-inflammatory prophylaxis is usually administered parallel to surgery.

The main purpose of this thesis was to provide clinical evidence that can be used for optimizing prophylactic anti-inflammatory treatment administered parallel to standard uncomplicated cataract surgery. We conducted a large randomized controlled trial where we assessed five main questions: (1) Is combination of steroid and non-steroidal anti-inflammatory drugs (NSAIDs) superior to NSAID monotherapy? (2) Is preoperative initiation of eye drop prophylaxis superior to initiation on the day of surgery? (3) Can dropless surgery replace eye drops? (4) What is the effect of early postoperative inflammation on macular thickening? (5) Is subjective visual outcome affected by choice of prophylactic regimen?

Based on our results, NSAID eye drop monotherapy with initiation on the day of surgery may be preferred in standard uncomplicated cataract surgery.