Treatment modalities of pseudophakic cystoid macular edema

Hariharasubramanian Kasthuribai, A. Kowsalya, Sharmila Rajendrababu, A. Pathak
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Abstract

Purpose: To evaluate the clinical profile of cystoid macular edema (CME) following cataract extraction and to assess the response to various treatment modalities. Methods: This was a prospective analysis of all patients diagnosed with CME after cataract surgery conducted in the period from July 2018 to July 2019. Patients were divided into three groups based on their degree of visual impairment. Patients whose visual acuity (VA) ranged from 6/6 to 6/18 were allotted Group A and were treated with topical prednisolone acetate 1% and topical ketorolac tromethamine 0.5%. Group B included patients whose VA ranged from 6/24 to 6/36 and were treated with periocular injection of 40 mg triamcinolone acetonide (TA). Patients with VA <6/60 were allotted Group C and were treated with intravitreal injection of 4 mg TA. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and optical coherence tomography (OCT) findings were recorded at 1-month follow-up. Results: A total of 53.3% developed CME in the first 4–6 weeks post-operatively. CME was more common in patients who underwent extracapsular cataract extraction (ECCE). A total of 75% of patients in Group A, 86.36% in Group B and 66.66% in Group C showed complete resolution of CME at 1-month follow-up. The difference between the pre-treatment and post-treatment macular thickness measured by OCT was statistically significant (P < 0.05) for all groups. Conclusion: CME occurring after cataract surgery usually presents within 4–6 weeks of surgery. Topical non-steroidal anti-inflammatory drugs (NSAIDs) and periocular steroids are effective in the management of pseudophakic CME. However, the choice of treatment is individualised to the patient's needs.
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人工晶状体黄斑囊样水肿的治疗方法
目的:评估白内障摘除术后囊样黄斑水肿(CME)的临床特点,并评估对各种治疗方式的反应。方法:这是对2018年7月至2019年7月期间白内障手术后诊断为CME的所有患者的前瞻性分析。根据患者的视力受损程度将其分为三组。视力(VA)范围为6/6至6/18的患者被分为A组,局部使用1%醋酸泼尼松和0.5%酮咯酸氨丁三醇治疗。B组包括视力范围为6/24至6/36的患者,眼部注射40mg曲安奈德(TA)治疗。VA<6/60的患者被分配到C组,并接受玻璃体内注射4mg TA的治疗。在1个月的随访中记录最佳矫正视力(BCVA)、眼压(IOP)和光学相干断层扫描(OCT)结果。结果:53.3%的患者在术后前4-6周出现CME。CME在接受白内障囊外摘除术(ECCE)的患者中更常见。在1个月的随访中,A组75%的患者、B组86.36%的患者和C组66.66%的患者显示CME完全消退。OCT测量的治疗前和治疗后黄斑厚度之间的差异在所有组中具有统计学意义(P<0.05)。结论:白内障手术后发生的CME通常在手术后4-6周内出现。局部非甾体抗炎药(NSAIDs)和眼周类固醇在治疗人工晶状体CME方面是有效的。然而,治疗的选择是根据患者的需要进行个性化的。
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