What’s your approach to managing postoperative inflammation and CME in high-risk patients after cataract surgery?

As a retinal specialist, I often receive referrals from my cataract surgery colleagues for patients with cystoid macular edema (CME) post-cataract surgery. My initial approach involves topical steroids combined with a topical NSAID. I re-evaluate these patients in two to four weeks to assess for anatomic and functional improvement.

If there's positive movement—resolution of fluid on structural OCT +/- improved visual acuity—I continue the topical therapy until complete resolution of the CME. Once resolved, I initiate a month-long taper of the topical steroid while maintaining the NSAID throughout. I will assess for recurrence with a follow-up evaluation a few weeks after discontinuing the steroid. If the macular edema remains quiescent at t...