Routine use of non-steroidal drops after cataract surgery

There are two types of eye drop that can be used to control eye inflammation following cataract surgery – steroid drops, and non-steroidal drops (the latter of which are the eye drop equivalent of something like ibuprofen). Of the two classes, steroid drops are more effective (potent) and almost all surgeons routinely prescribe them following eye surgery.

The pharmaceutical industry have heavily promoted the routine use of non-steroidal drops after surgery, in addition to steroid drops. In America, most surgeons routinely use both type of drop following surgery, despite a lack of compelling evidence that the addition of non-steroidal drops improves visual outcomes.

This editorial in the leading journal Ophthalmology robustly challenges the rationale for this and – to my eye – is a reassuring vindication of the British practice which in many centres is to use only steroid drops routinely following surgery. Of note is a recent randomised controlled trial indicating that neither of 2 commonly prescribed non-steroidal agents were better than a placebo in reducing the incidence of macular swelling after surgery. (may require subscription)