Min Lang, Jie Xuan, Xue Li, Ming-Ming Liu, Jie Xu, Ting Liu
{"title":"非甾体抗炎药预防白内障术后黄斑水肿的比较疗效：系统综述和网络荟萃分析。","authors":"Min Lang, Jie Xuan, Xue Li, Ming-Ming Liu, Jie Xu, Ting Liu","doi":"10.18240/ijo.2025.09.15","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To assess and rank the efficacy of various non-steroidal anti-inflammatory drugs (NSAIDs) in preventing postoperative macular edema (PME) after cataract surgery.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Web of Science databases. Randomized controlled trials (RCTs) comparing different NSAIDs and control treatments for the prevention of PME were included. Data from the studies were synthesized using the \"gemtc\" package in R. Risk of bias was assessed with the Cochrane RoB 2 tool, and heterogeneity was evaluated using the global <i>I</i> <sup>2</sup> statistic. Surface under the cumulative ranking curve (SUCRA) values were calculated for each treatment.</p><p><strong>Results: </strong>Of 132 identified records, 9 RCTs met the inclusion criteria. The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME, followed by artificial tear substitute, ketorolac, diclofenac, and bromfenac. The league table comparisons and rankograms corroborated these findings, with nepafenac consistently ranking highest. Heterogeneity analysis yielded high <i>I</i> <sup>2</sup> values, indicating substantial variability across studies.</p><p><strong>Conclusion: </strong>This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery. Given the substantial heterogeneity observed, further high-quality RCTs are required to confirm these findings and explore the sources of variability. Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"18 9","pages":"1730-1736"},"PeriodicalIF":1.8000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378685/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysis.\",\"authors\":\"Min Lang, Jie Xuan, Xue Li, Ming-Ming Liu, Jie Xu, Ting Liu\",\"doi\":\"10.18240/ijo.2025.09.15\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To assess and rank the efficacy of various non-steroidal anti-inflammatory drugs (NSAIDs) in preventing postoperative macular edema (PME) after cataract surgery.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Web of Science databases. Randomized controlled trials (RCTs) comparing different NSAIDs and control treatments for the prevention of PME were included. Data from the studies were synthesized using the \\\"gemtc\\\" package in R. Risk of bias was assessed with the Cochrane RoB 2 tool, and heterogeneity was evaluated using the global <i>I</i> <sup>2</sup> statistic. Surface under the cumulative ranking curve (SUCRA) values were calculated for each treatment.</p><p><strong>Results: </strong>Of 132 identified records, 9 RCTs met the inclusion criteria. The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME, followed by artificial tear substitute, ketorolac, diclofenac, and bromfenac. The league table comparisons and rankograms corroborated these findings, with nepafenac consistently ranking highest. Heterogeneity analysis yielded high <i>I</i> <sup>2</sup> values, indicating substantial variability across studies.</p><p><strong>Conclusion: </strong>This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery. Given the substantial heterogeneity observed, further high-quality RCTs are required to confirm these findings and explore the sources of variability. Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.</p>\",\"PeriodicalId\":14312,\"journal\":{\"name\":\"International journal of ophthalmology\",\"volume\":\"18 9\",\"pages\":\"1730-1736\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378685/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.18240/ijo.2025.09.15\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18240/ijo.2025.09.15","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：评价各种非甾体类抗炎药（NSAIDs）预防白内障术后黄斑水肿（PME）的疗效并进行分级。方法：综合检索PubMed、Embase、Cochrane Library和Web of Science数据库。包括比较不同非甾体抗炎药和对照治疗预防PME的随机对照试验（rct）。这些研究的数据采用r中的“gemtc”软件包进行综合。偏倚风险采用Cochrane RoB 2工具进行评估，异质性采用全球i2统计量进行评估。计算每个处理的累积排序曲线下曲面（SUCRA）值。结果：132例纳入记录中，9例rct符合纳入标准。网络meta分析显示，neafenac对PME的预防效果最高，其次是人工泪液代用品、酮洛酸、双氯芬酸和溴芬酸。排名表的比较和排名证实了这些发现，neafenac一直排名最高。异质性分析得出较高的i2值，表明研究之间存在很大的差异。结论：本网络荟萃分析表明，neafenac是预防白内障手术后PME最有效的非甾体抗炎药。鉴于观察到的大量异质性，需要进一步的高质量随机对照试验来证实这些发现并探索变异的来源。临床医生在为白内障手术患者选择非甾体抗炎药预防PME时应考虑这些结果。
Comparative efficacy of non-steroidal anti-inflammatory drugs in preventing postoperative macular edema following cataract surgery: a systematic review and Network Meta-analysis.
Aim: To assess and rank the efficacy of various non-steroidal anti-inflammatory drugs (NSAIDs) in preventing postoperative macular edema (PME) after cataract surgery.
Methods: A comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Web of Science databases. Randomized controlled trials (RCTs) comparing different NSAIDs and control treatments for the prevention of PME were included. Data from the studies were synthesized using the "gemtc" package in R. Risk of bias was assessed with the Cochrane RoB 2 tool, and heterogeneity was evaluated using the global I2 statistic. Surface under the cumulative ranking curve (SUCRA) values were calculated for each treatment.
Results: Of 132 identified records, 9 RCTs met the inclusion criteria. The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME, followed by artificial tear substitute, ketorolac, diclofenac, and bromfenac. The league table comparisons and rankograms corroborated these findings, with nepafenac consistently ranking highest. Heterogeneity analysis yielded high I2 values, indicating substantial variability across studies.
Conclusion: This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery. Given the substantial heterogeneity observed, further high-quality RCTs are required to confirm these findings and explore the sources of variability. Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.
期刊介绍：
· International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication
and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online).
This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from
WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed,
PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166.
IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific
Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO);
Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President,
Chinese Academy of Engineering.
International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of
blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of
AAO/PAAO) et al.
Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of
Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and
Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society).
Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press).
Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and
Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics).
Associate Editors-in-Chief include:
Prof. Ning-Li Wang (President Elect of APAO);
Prof. Ke Yao (President of Chinese Ophthalmological Society) ;
Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ;
Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA);
Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society);
Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA);
Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA).
IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles,
both basic and clinical papers.
Instruction is Welcome Contribution is Welcome Citation is Welcome
Cooperation organization
International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
