Comparison of the efficacy of nepafenac with or without dexamethasone for preventing pseudophakic cystoid macular edema

Aim To compare the efficacy of nepafenac monotherapy with the combination of nepafenac and dexamethasone for preventing pseudophakic cystoid macular edema (PCME), one of the most common complications after cataract surgery. Methods This retrospective study included patients who underwent uncomplicated cataract surgery. They were divided into two groups: Group 1 (Monotherapy) received nepafenac alone, while Group 2 (Combination Therapy) received nepafenac with dexamethasone. Postoperative central macular thickness and cystoid changes were monitored using optical coherence tomography (OCT). Statistical analyses were performed to compare the efficacy of both regimens in preventing PCME. Results Both treatment groups were effective in reducing macular thickening and lowering the risk of clinically significant PCME. However, no statistically significant difference in efficacy was found between nepafenac monotherapy and combination therapy. This finding suggests that adding dexamethasone did not confer a measurable advantage in preventing PCME compared with nepafenac alone. Conclusion Our study demonstrates that nepafenac monotherapy is as effective as combination therapy for PCME prophylaxis. The lack of additional benefit from the combination suggests that monotherapy may be a more practical approach, as it can improve patient compliance, reduce side effects, and simplify the treatment regimen. Although our study has limitations, including a small sample size and the use of a single NSAID, our findings contribute to the literature supporting NSAID monotherapy in postoperative cataract management. Larger, randomized controlled trials are needed to confirm these results.