目的：系统评价白内障超声乳化吸除术前加用非甾体抗炎药(nonsteroidal anti-inflammatory drugs，NSAIDs)对术后黄斑囊样水肿(cystoid macular edema，CME)的影响。

方法：计算机检索Cochrane Library、PubMed、BMC、中国期刊全文数据库(CNKI)、维普中文期刊数据库(VIP)。收集NSAIDs的不同给药时机(试验组予以NSAIDs术前及术后局部点眼治疗，对照组予以NSAIDs术后治疗)对白内障超声乳化吸除术后CME及黄斑中心凹厚度影响的临床随机对照试验文献。采用RevMan 5.2软件及Stata12.0软件进行Meta分析。

结果：共纳入6项研究。术前是否加用NSAIDs对白内障超声乳化吸除术后CME的发生在术后1wk差异无统计学意义(OR=1.58，95%CI：0.48～5.18，P>0.05)、术后1mo差异无统计学意义(OR=0.78，95%CI：0.30～2.00，P>0.05)，术后3mo差异有统计学意义(OR=0.22，95%CI：0.11～0.43，P<0.01)； 黄斑中心凹厚度在术后1wk差异无统计学意义(WMD=-7.20，95%CI：-15.17～0.77，P>0.05)、术后1mo差异无统计学意义(WMD=-3.98，95%CI：-14.05～6.08，P>0.05)，术后3mo差异有统计学意义(WMD=-18.25，95%CI：-33.80～-2.70，P<0.05)。

结论：术前及术后联合应用NSAIDs治疗可以显著降低白内障超声乳化吸除术后CME的发生，降低术后黄斑中心凹的厚度，提示NSAIDs的术前术后联合应用较单独术后应用更具有优越性。

METHODS: The Cochrane Library, PubMed, BMC, National Knowledge Infrastructure(CNKI), and VIP databases were searched to identify the clinical randomized controlled trials of comparing effects of NSAIDs administered at different time points on the incidence of CME and the central foveal thickness following phacoemulsification. The experiment group received topical NSAIDs preoperatively and postoperatively, while the control group received topical NSAIDs postoperatively. The RevMan software 5.2 and Stata software 12.0 were used in the Meta-analysis.

RESULTS: Six studies were included in this Meta-analysis. No statistically differences were observed in the incidence of CME after 1wk postoperatively(OR=1.58, 95%CI: 0.48-5.18, P>0.05), in the incidence of CME after 1mo postoperatively(OR=0.78, 95%CI: 0.30-2.00, P>0.05), in the central foveal thickness after 1wk postoperatively(WMD=-7.20, 95%CI: -15.17 to 0.77, P>0.05), and in the central foveal thickness after 1mo postoperatively(WMD=-3.98, 95%CI: -14.05 to 6.08, P>0.05). However, statistically significant differences were found in the incidence of CME after 3mo postoperatively (OR=0.22, 95%CI: 0.11-0.43, P<0.01)and in the central foveal thickness after 3mo postoperatively(WMD=-18.25, 95%CI: -33.80 to -2.70, P<0.05).

CONCLUSION: A combination of NSAIDs administrated preoperatively and postoperatively can reduce the incidence of the CME and the thickness of the macular centrall. Thereby, the effects of administrating NSAIDs both preoperatively and postoperatively have more advantages than that of administrating NSAIDs postoperatively alone.