***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The purpose of this study was to evaluate nepafenac ophthalmic suspension 0.1 % ( Nevanac ® ; Alcon Research Ltd ) in the prevention of macular edema following cataract surgery in diabetic retinopathy patients . Methods This was a multicenter , r and omized , double-masked , vehicle-controlled study of 263 adult diabetic patients with nonproliferative diabetic retinopathy requiring cataract surgery . Patients were r and omized ( 1:1 ) to instill nepafenac or vehicle three times daily beginning 1 day prior to surgery through day 90 . Efficacy included the percentage of patients who developed macular edema ( ≥30 % increase in central subfield macular thickness from baseline ) and the percentage of patients with decreases of more than five letters in best-corrected visual acuity from day 7 to 90 . Results A significantly lower percentage of patients in the nepafenac group developed macular edema relative to patients in the vehicle group ( 3.2 % versus 16.7 % ; P < 0.001 ) . A significantly lower percentage of patients in the nepafenac group had best-corrected visual acuity decreases of more than five letters relative to patients in the vehicle group on day 30 ( P < 0.001 ) , day 60 ( P = 0.002 ) , and day 90 ( P = 0.006 ) . The mean central subfield macular thickness and mean percent change from baseline in macular volume were also significantly lower in the nepafenac group versus the vehicle group at days 14 through 90 ( P ≤ 0.005 ) . No safety issues or trends were identified when dosing was increased to 90 days that negatively impacted the favorable benefit/risk profile of nepafenac . Conclusion Nepafenac demonstrated statistically significant and clinical ly relevant advantages compared with vehicle in preventing macular edema and maintaining visual acuity in diabetic patients following cataract surgery . These advantages were seen at multiple time points over the course of the 90-day therapy period . There was no clinical ly relevant increase in risk from 90 days dosing compared with 14 days . Therefore , with a similar safety profile and benefit in preventing macular edema and maintaining vision , the risk/benefit to the diabetic patient undergoing cataract surgery appears to be positive Purpose To evaluate the use of topical nepafenac 0.1 % after routine phacoemulsification in patients at low risk for cystoid macular oedema ( CME ) using optical coherence tomography ( OCT ) measurement of macular thickness . Methods Seventy-nine subjects with no risk factors for CME had uncomplicated bimanual micro-incision cataract surgery by an experienced surgeon . All subjects received preoperative nepafenac . Subjects were r and omised to postoperative st and ard of care , consisting of a topical antibiotic for 10 days and topical corticosteroid for 1 month ( control ) , or st and ard of care plus nepafenac for 1 month ( treatment ) . OCT and ETDRS best-corrected visual acuity were measured preoperatively and 2 months postoperatively . Primary endpoints were comparison of changes in macular thickness between groups and the relationship of that change to postoperative vision . Results All subjects had excellent visual outcomes , with mean visual improvement of 15 letters . Cataract surgery was very efficient with a mean effective phaco time ( EPT ) of 4.99 and 6.90 s in the control and treatment groups , respectively . There were small increases in the central macular thickness in both the control ( 2.78 μm ) and treatment ( 5.60 μm ) groups . The change in macular thickness was statistically similar between groups and did not correlate with the final visual outcome . Discussion The small increase in macular thickness after routine cataract surgery is probably not clinical ly significant . In subjects undergoing routine cataract surgery , and at low risk for CME , the routine use of preoperative nepafenac may be all that is necessary to achieve excellent visual recovery PURPOSE To access the necessity of topical steroids  after uneventful cataract surgery , phaco-emulsification/aspiration plus intraocular lens ( PEA+IOL ) implantation . DESIGN Single-blind , r and omized , prospect i ve study . PARTICIPANTS Twenty-one patients were prospect ively r and omized , 11 patients were assigned to the steroid group , and 10 to the non-steroid group . METHODS Between March and September 2007 , in Mino Tanaka Hospital in Tokushima Prefecture , Japan , we performed PEA+IOL  in 28 eyes of 21 patients and examined the visual acuity , corneal endothelium cell density , and anterior aqueous flare value after dividing all the patients into 2 groups , the topical steroid use and the non-steroid group . RESULTS At 1 month postoperatively , no difference was observed between the 2 groups in terms of the outcomes described , and no cystoid macular edema was detected . CONCLUSION Topical steroid medication may not be absolutely essential after uneventful PEA+IOL Purpose To compare the anti-inflammatory efficacy of ketorolac of tromethamine 0.4 % and nepafenac 0.1 % eye drops for prophylaxis of cystoid macular oedema ( CME ) after small-incision cataract extraction . Methods Patients were assigned r and omly to three groups . Group 1 patients received a topical artificial tear substitute ( placebo ) ; group 2 received ketorolac tromethamine 0.4 % ( Acular LS , Allergan ) and group 3 received nepafenac 0.1 % ( Nevanac , Alcon ) . The incidence and severity of CME were evaluated by retinal foveal thickness on optical coherence tomography ( OCT ) after 1 , 4 and 12 weeks . Results One hundred and twenty-six eyes of 126 patients were included in this study . The between-group differences in visual outcomes , central corneal thickness and endothelial cell density were not statistically significant . In all retinal thickness measurements , an increase was detected starting from the postoperative first week until 12 weeks . There was no statistically significant difference between the three groups in any measurement performed by spectral-domain OCT . Conclusions Used prophylactically after uneventful cataract surgery , non-steroidal anti-inflammatory drugs were not efficacious in preventing macular oedema compared with placebo . Trial registration number Clinical Trials : NCT02084576 PURPOSE : To evaluate the effectiveness of a nonsteroidal antiinflammatory drug ( NSAID ) on  pseudophakic cystoid macular edema (  CME ) and determine the efficacy when used preoperatively and after uneventful phacoemulsification surgery . SETTING : Department of Ophthalmology , Kocatepe University , School of Medicine , Afyonkarahisar , Turkey . METHODS : One hundred seventy‐nine eyes of 189 patients having uneventful phacoemulsification surgery were enrolled in the study . After surgery , all patients used topical steroids and antibiotics 4 times daily . Sixty‐one eyes , chosen r and omly , received a topical NSAID ( indomethacin ) 4 times daily for 3 days preoperatively and 1 month postoperatively . Sixty eyes received topical indomethacin 4 times daily for 1 month postoperatively . Fifty‐eight eyes served as a control group and received only topical steroids and antibiotics . At the third postoperative month , visual acuity , fluorescein angiograms , and macular thresholds were evaluated . Statistical analysis was by chi‐square and 1‐way analysis of variance tests . RESULTS : Cystoid macular edema was not seen in the group receiving indomethacin preoperatively and postoperatively . The incidence of angiographic CME was 15.0 % in the group receiving postoperative indomethacin and 32.8 % in the control group ( P<.001 ) . Mean sensitivity in the macular threshold test did not show a significant change between groups ( P = .83 ) . Postoperative visual acuity was significantly higher in the group receiving preoperative indomethacin ( P<.001 ) . CONCLUSION : Nonsteroidal antiinflammatory drugs  decreased the incidence of CME , and their efficacy increased when begun preoperatively PURPOSE To evaluate whether adding perioperative topical ketorolac tromethamine 0.4 % improves cataract surgery outcomes relative to topical steroids alone in patients without known risk factors for cystoid macular edema ( CME ) . DESIGN Prospect i ve , r and omized , investigator-masked , multicenter clinical trial . METHODS Patients scheduled to undergo phacoemulsification and with no recognized CME risks ( diabetic retinopathy , retinal vascular disease , or macular abnormality ) were r and omized to receive either prednisolone acetate 1 % 4 times daily ( QID ) alone ( steroid group ; n = 278 ) or prednisolone 1 % QID plus ketorolac 0.4 % QID ( ketorolac/steroid group ; n = 268 ) for approximately four weeks postoperatively . In the ketorolac/steroid group , patients also received topical ketorolac 0.4 % QID for three days preoperatively . In both groups , patients received four doses of ketorolac 0.4 % one hour before surgery . Patients with capsular disruption or vitreous loss intraoperatively were exited from the study . Outcome measures included CME incidence , retinal thickness as measured by optical coherence tomography ( OCT ) , best-corrected visual acuity , and contrast sensitivity . RESULTS No patients in the ketorolac/steroid group and five patients in the steroid group had clinical ly apparent CME ( P = .032 ) . Based on OCT , no ketorolac/steroid patient had definite or probable CME , compared with six steroid patients ( 2.4 % ; P = .018 ) . In the ketorolac/steroid group , mean retinal thickening was less ( 3.9 microm vs 9.6 microm ; P = .003 ) , and fewer patients had retinal thickening of more than 10 microm as compared with the steroid group ( 26 % vs 51 % ; P < .001 ) . CONCLUSIONS This study suggests that adding perioperative ketorolac to postoperative prednisolone significantly reduces the incidences of CME and macular thickening in cataract surgery patients already at low risk for this condition Purpose To evaluate the efficacy of adding nepafenac 0.1 % ophthalmic suspension to dexamethasone 0.1 % eyedrops in controlling macular swelling and other manifestations of inflammation  after uneventful cataract surgery . Setting Ophthalmology Department , Mölndal Hospital , Gothenburg , and St. Erik Eye Hospital , Stockholm , Sweden . Design R and omized double‐masked clinical trial . Methods Patients at low risk for postoperative inflammation were recruited and r and omized to the nepafenac  group or to the  control group .  Postoperative swelling of the macula was assessed with ocular coherence tomography . Laser flare intensity , corrected distance visual acuity , ocular discomfort , and visual complaints were also recorded . Results The analysis of intent‐to‐treat population comprised 75 patients in the nepafenac group and 77 patients in the control group . Compared with the control regimen , add‐on nepafenac result ed in statistically significant reductions in the following parameters : change in macular volume at 3 weeks and 6 weeks ( P<.001 ) , proportion of patients with more than 10 & mgr;m of swelling in the central macula at 3 weeks ( P<.0001 ) and 6 weeks ( P=.02 ) , mean laser flare intensity at 1 day ( P=.029 ) , pain during the first 24 hours postoperatively ( P<.0001 ) , and ocular discomfort and photophobia during the first 3 postoperative weeks ( P=.0058 and P=.0052 , respectively ) . Conclusion The combination of topical nepafenac and steroid treatment reduced sub clinical macular swelling and inflammation as well as subjective complaints , indicating it is an efficient antiinflammatory regimen after cataract surgery . Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned Purpose : To compare bromfenac sodium 0.1 % , fluorometholone 0.1 % and dexamethasone 0.1 % for the control of postoperative inflammation and prevention of cystoid macular edema ( CME ) after phacoemulsification . Methods : Patients were r and omized to receive bromfenac sodium 0.1 % for 1 month ( OBS1 ) or 2 months ( OBS2 ) , or fluorometholone 0.1 % for 1 month ( OFM ) or dexamethasone 0.1 % for 1 month ( ODM ) . Best-corrected visual acuity , intraocular pressure , endothelial cell density , photon count value and retinal foveal thickness were measured . Results : Mean photon count values were lower in the OBS1 and OBS2 groups compared with the ODM group during the first week . Bromfenac sodium  cleared the ocular inflammation more rapidly than fluorometholone and dexamethasone . The foveal thickness was thinner in the second month and the incidence of CME was lower in the OBS1 and OBS2 groups compared with the OFM and ODM groups . Conclusion : Bromfenac sodium was more effective and safer than fluorometholone and dexamethasone as an anti-inflammatory , decreasing macular thickness and preventing 
    Output:
    
We did not note any major adverse events - the main consistent observation was burning or stinging sensation with the use of NSAIDs .
Using topical NSAIDs may reduce the risk of developing macular oedema after cataract surgery , although it is possible that current estimates as to the size of this reduction are exaggerated .
It is unclear the extent to which this reduction has an impact on the visual function and quality of life of patients .
There is little evidence to suggest any important effect on vision after surgery .
Future trials should address the remaining clinical uncertainty of whether prophylactic topical NSAIDs are of benefit , particularly with respect to longer-term follow-up ( at least to 12 months ) , and should be large enough to detect reduction in the risk of the outcome of most interest to patients , which is chronic macular oedema leading to visual loss