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  • Cystoid macular oedema following cataract surgery

Cystoid macular oedema following cataract surgery
Reviewed by Ivan Yip

1 October 2019 | Ivan Yip | EYE - Cataract, EYE - Refractive | NSAIDs, cataract, cataract surgery, corticosteroids, cystoid macular oedema

This review covers the history, incidence, diagnosis, risk factors, pathophysiology and medical management of postoperative macular oedema (PCMO), with a particular emphasis on key contemporary studies and novel observations. The authors revisit the incidence of well-established risk factors including intraoperative complications such as posterior capsule rupture and preoperative factors including: diabetes mellitus, uveitis, retinal vein occlusion, epiretinal membrane. The role of topical glaucoma medications in PCMO is debated. Treatment strategies largely target suppression of inflammation. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids remain the mainstay in prophylaxis and treatment of PCMO. Other more novel treatment modalities are lacking in high quality trials and include: periocular corticosteroids, orbital floor triamcinolone, intravitreal triamcinolone, corticosteroid implants, intravitreal bevacizumab and pars plana vitrectomy. The authors highlight the main factor in reaching a conclusion is a result of a lack of consistency in defining PCMO and the resolution of PCMO (i.e. angiography, OCT, clinical) and explains why even large trials and systematic reviews come to contradictory conclusions.

Cystoid macular oedema following cataract surgery: a review.
Han J, Patel D, Squirrell D, McGhee C.
CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
2019;47:346-56.
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Ivan Yip

Alder Hey Children's Hospital, Liverpool, UK.

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