A Retrospective Data Analysis of Patients Treated with Difluprednate and Bromfenac for Cystoid Macular Edema After Uveitis or Cataract Surgery

Purpose: Cystoid macular edema (CME) is a condition which severely limits central vision, often occurring secondary to cataract surgery or uveitis. Although commonly treated with non-steroidal anti-inflammatory agents and a corticosteroid adjunct, an optimal medication regime has not yet been evaluated. Hence, we present a comprehensive analysis of the efficacy and relapse rate associated with various agents to treat CME, such as Bromfenac and Difluprednate. Patients and Methods: A retrospective chart review was conducted on patients aged 18 and above diagnosed with postoperative or uveitic CME via optical coherence tomography from January 1, 2016, to December 31, 2023. Among these eligible patients, we investigated those treated with non-steroidal anti-inflammatory drugs (NSAIDs) and/or corticosteroids. The primary outcome was the duration until complete resolution of CME. Secondary outcomes included improvement of CME and the likelihood of CME recurrence after treatment. Statistical analysis involved ANOVA and Tukey's HSD test to compare treatment efficacy. Results: A total of 518 patients were analyzed. Difluprednate and bromfenac (n = 28) demonstrated the shortest mean resolution time (1.45 months) compared to other combinations. The ANOVA test revealed significant differences among treatment groups (F-value: 6.455, P-value: <0.00001), and Tukey's HSD test showed that difluprednate and bromfenac significantly outperformed other medications in treating cystoid macular edema (CME) by reducing resolution times by 5.40 months compared to ketorolac alone (P = 0.0011), 4.76 months compared to ketorolac and prednisolone acetate (P = 0.0001), 5.42 months compared to loteprednol and nepafenac (P < 0.0001), 5.40 months compared to dexamethasone and nepafenac (P < 0.0001), and 4.47 months compared to no treatment (P = 0.0240). Difluprednate and bromfenac also had no cases of CME recurrence. Conclusion: Difluprednate and bromfenac proved to be the most effective treatment regimen for cystoid macular edema (CME), resolving the condition in the shortest amount of time and requiring less frequent dosing.