Cataract surgery corneal edema

Although oral NSAIDs have application to ophthalmic pain management, topical NSAIDs have the more immediate utility. Some of the earliest indications for topical NSAIDs were prophylaxis and treatment for cystoid macular edema (CME) as well as pain and inflammation management after cataract surgery.This pioneering work ras done befiare the introduction of less traumatic procedures such as clear corneal incisions. The seminal investigations using... 

Corneal edema is a common finding postoperatively after uncomplicated, sutureless, scleral tunnel or clear corneal incision cataract surgery. More severe involvement (Figure 30-5) with persistent stromal edema, epithelial microcysts, and bullae may be found in patients with low endothelial cell counts, excessive inflammation from corneal trauma during the surgery, or an increased lOP secondary to retained lens material or inflammatory response. Bullae are typically secondary to increased corneal aqueous absorption due to high lOP or to a breakdown of the corneal endothelial aqueous pump. 

Accidental use of cetrimide solution 0.1% as an irrigation solution during cataract surgery in two cases resulted in immediate corneal edema, which in turn resulted in a severe bullous keratopathy (2). 

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