Cystoid Macular Edema Associated with Latanoprost Therapy in a Pseudophakic Vitrectomized Patient after Removal of Silicone Oil Endotamponade

2003 ◽  
Vol 13 (2) ◽  
pp. 221-222 ◽  
Author(s):  
M. Jäger ◽  
J.B. Jonas
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Silicone Oil ◽  
Open Angle Glaucoma ◽  
Vitreous Body ◽  
Corticosteroid Treatment ◽  
Posterior Chamber ◽  
Eye Drops

Purpose To describe the occurrence of cystoid macular edema in a pseudophakic vitrectomized patient following use of latanoprost (0.005%). Methods A 58-year-old patient underwent routine cataract surgery with posterior chamber lens implantation complicated by rhegmatogenous retinal detachment three months later. A pars plana vitrectomy was performed with silicone oil endotamponade which was removed six months later. Five months after oil removal, the patient presented with secondary open-angle glaucoma treated with latanoprost 0.005% eye drops once daily. Results Two weeks after initiation of latanoprost treatment, visual acuity dropped from 0.8 to 0.3 due to cystoid macular edema confirmed by fluorescein angiography. After discontinuing latanoprost therapy and with topical corticosteroid treatment, cystoid macular edema slowly resolved, and within 6 months, visual acuity improved to 0.8. Conclusions Despite its marked ocular hypotensive effect, latanoprost should be carefully used in patients after uncomplicated cataract surgery if the vitreous body was removed by pars piana vitrectomy.

scholarly journals Treatment of cystoid macular edema in a patient with primary open angle glaucoma and diabetic retinopathy by withdrawal of travoprost

2021 ◽  
Vol 7 (2) ◽  
pp. 180-183
Author(s):  
Shiv Sagar N ◽  
BN Kalpana ◽  
Shilpa YD
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Cystoid Macular Edema ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Antiglaucoma Medication ◽  
Micropulse Laser

To study the association of cystoid macular edema (CME) and Travoprost eye drops in a patient with diabetic retinopathy (DR).The study was carried out on a 65yr old patient on a regular follow up from 2009-2018.A 65yr old patient of a DR of both eyes who had received 3 sittings of pan retinal photocoagulation (PRP) laser in both eyes and grid laser to his right eye. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Patient was also on topical antiglaucoma medication and had prophylactic YAG-PI done both eyes. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Right eye showed macular edema (ME) in 2014 and underwent OCT and FFA. Patient refused for intravitreal injection and preferred laser treatment, so patient underwent micropulse laser treatment in 2014. His edema persisted even after micropulse treatment. His systemic control was good and patient continued to use Travoprost eye drops. So in 2017 suspected CME secondary to topical prostaglandin (PG) analogue as he had strict glycemic control and was no fluctuation in ME. Hence topical PG analogue was withdrawn and stopped. On subsequent follow up after 2 months CME had completely disappeared and the foveal contour returned to normal on OCT. LE was status quo. Patient was followed up for more than 1 year and continuously followed up, 15 days back in June 2018 had no evidence of CME and vision was 6/9 in both eyes.: Differentiation of DME and CME secondary to PG analogue should be made at the earliest.

Subthreshold micropulse yellow laser for the management of refractory cystoid macular edema consequent to complicated cataract surgery

2020 ◽  
pp. 112067212092800
Author(s):  
Tommaso Verdina ◽  
Cecilia Ferrari ◽  
Edoardo Valerio ◽  
Alberto Brombin ◽  
Andrea Lazzerini ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Laser Treatment ◽  
Cystoid Macular Edema ◽  
Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Complicated Cataract ◽  
Yellow Laser ◽  
Best Corrected Visual Acuity

Purpose: To report the safety and efficacy of subthreshold micropulse yellow laser of 577 nm for a complex case of refractory pseudophakic cystoid macular edema. Methods: A retrospective chart review of an interventional case report of three subthreshold micropulse yellow laser interventions for refractory pseudophakic cystoid macular edema. Patient: A 77-year-old healthy female underwent pseudoexfoliative cataract surgery complicated by posterior capsule rupture and sulcus intraocular lens implantation. After 3 months, she required a scleral fixation of the same lens, due to a lack of capsular support and decentration of the intraocular lens. One month later, she experienced a severe pseudophakic cystoid macular edema (foveal thickness of 399 µm and best-corrected visual acuity of 20/80 Snellen). The condition was refractory to conventional treatments prior to subthreshold micropulse yellow laser interventions, including non-steroidal anti-inflammatory eye drops, topical steroids, oral indomethacin and three sub-Tenon’s triamcinolone injections, attempted over a 14-month period. Results: Subthreshold micropulse yellow laser treatment was performed and immediate resolution was achieved and maintained for 2 months. Two cases of edema relapse were observed at 3 months from initial laser treatment and again at 4 months from the second laser treatment. Final patient’s follow-up at 6 months from the third laser treatment evidenced the absence of edema, improved visual acuity (foveal thickness of 265 µm/best-corrected visual acuity of 20/30 Snellen) and the absence of complications. Conclusions: Subthreshold micropulse yellow laser seems to be a safe and effective treatment for short-term resolution of refractory pseudophakic cystoid macular edema after complicated cataract surgery and represents a useful alternative to expensive and invasive therapies. A trend towards a longer duration of edema resolution with every subthreshold micropulse yellow laser repetition was observed.

scholarly journals Ocular Decompression Retinopathy with Macular Edema after Deep Sclerectomy with Intrascleral Implantation

2020 ◽  
Vol 11 (1) ◽  
pp. 151-155
Author(s):  
Pablo Diaz Aljaro ◽  
Jordi Loscos Arenas ◽  
Laura Broc Iturralde ◽  
Marc Carbonell Puig ◽  
Pau Romera Romero
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Medical Therapy ◽  
Open Angle Glaucoma ◽  
Retinal Hemorrhage ◽  
Eye Drops ◽  
Medical Procedure ◽  
Deep Sclerectomy ◽  
Pars Plana ◽  
Decompression Retinopathy

We report a case of ocular decompression retinopathy (ODR) with macular edema, diagnosed by optical coherence tomography, after a deep sclerectomy (DS) with an intrascleral implant, resolved with medical therapy 6 months later. The medical literature reports that in 14% of patients suffering from ODR, a pars plana vitrectomy was required, and 15% of patients had a poor final visual acuity. An otherwise healthy 75-year-old man with high myopia and a primary open-angle glaucoma, with previous intraocular pressure (IOP) of 24 mm Hg, underwent a DS with intrascleral implant without complications. The patient suffered postoperatively from ODR with macular edema that required medical therapy with nonsteroidal anti-inflammatory eye drops (Nepafenac® 0.3%) for a period of 6 months. ODR is an infrequent complication that may occur after any surgical or medical procedure that causes a sudden IOP decrease. The presence of macular edema is only reported in 5% of cases and can occur in patients who report a decreased visual acuity, commonly associated with a retinal hemorrhage. We have described a case of ODR with macular edema after DS with intrascleral implant. Although ODR is considered to cause a low level of morbidity, in some patients this may not be the case.

scholarly journals Exophiala Endophthalmitis after Cataract Surgery

2021 ◽  
Vol 62 (10) ◽  
pp. 1435-1439
Author(s):  
Tae Hwan Kim ◽  
Moon Kyung Shin ◽  
Yoon Hyung Kwon
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Early Stage ◽  
Vitreous Body ◽  
Complete Removal ◽  
Eye Drops ◽  
Second Surgery ◽  
The Right

Purpose: To report a case of Exophiala endophthalmitis after cataract surgery, which has not been reported previously in Korea.Case summary: A 70-year-old woman visited the hospital 7 days after cataract surgery in her right eye with unilateral vision impairment. At the time of the visit, visual acuity of the right eye was hand motion, and the fundus was not clearly observed due to numerous inflammatory cells with hypopyon in the anterior chamber. With an initial diagnosis of suspected bacterial endophthalmitis, vitrectomy was performed immediately with intravitreal injection of antibiotics and steroid. On day 14 after vitrectomy, inflammation in the anterior chamber and vitreous opacity worsened, and complete vitrectomy, including of the vitreous base, and removal of the intraocular lens and capsule was performed. Exophiala was detected in the biopsy specimen on day 6 after the second surgery, and the patient was discharged with a prescription for voriconazole eye drops. On day 23 after the second surgery, the best-corrected visual acuity in the right eye had improved to 1.0, and there was no evidence of endophthalmitis recurrence and no observed additional abnormal findings of the fundus until 6 months after second surgery.Conclusions: In a case of fungal endophthalmitis that occurred after cataract surgery, good results were obtained by vitrectomy involving complete removal of the peripheral vitreous body, including the intraocular lens and lens capsule, which was the basis for growth of the fungus in the early stage of endophthalmitis.

scholarly journals Long-term Clinical Outcomes of Cataract Surgery in Patients with Retinitis Pigmentosa

2021 ◽  
Vol 62 (7) ◽  
pp. 931-938
Author(s):  
Ji Hyun Yoon ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Outcomes ◽  
Cystoid Macular Edema ◽  
Final Visit ◽  
Short Term ◽  
The Mean

Purpose: The long-term clinical outcomes of cataract surgery in patients with retinitis pigmentosa (RP) were evaluated. Methods: A retrospective analysis of medical records was performed for patients who were diagnosed with RP and underwent cataract surgery. Preoperative best-corrected visual acuity (BCVA) was compared with BCVA at 1 month postoperatively and at the final visit. The proportion of patients with cystoid macular edema development or aggravation after surgery was evaluated, as was the proportion of patients with intraocular lens subluxation/dislocation. For patients who underwent optical coherence tomography, factors associated with a BCVA of 0.5 or better at 1 month were analyzed. Results: In total, 133 eyes were included and the mean follow-up period was 58.7 months. The mean logarithm of minimal angle of resolution BCVA was 0.69 ± 0.65 at diagnosis. The BCVA was significantly improved to 0.51 ± 0.47 at 1 month postoperatively (p < 0.001). However, the BCVA at the final visit (0.70 ± 0.81) was similar to the baseline value (p = 1.000). Cystoid macular edema development or aggravation was noted in 8 eyes (6.0%) and intraocular lens subluxation/dislocation was noted in 4 eyes (3.0%). A subgroup analysis involving 108 eyes revealed that preoperative BCVA (p < 0.001) and ellipsoid zone status (p = 0.001) were associated with postoperative visual acuity. Conclusions: Short-term outcomes of cataract surgery in patients with RP were comparatively good. However, long-term visual deterioration was noted with disease progression. Preoperative BCVA and ellipsoid zone status are useful markers for predicting short-term visual outcomes.

scholarly journals Postsurgical Cystoid Macular Edema following Posterior Chamber Toric Phakic Intraocular Lens Implantation Surgery: A Case Report

2015 ◽  
Vol 6 (2) ◽  
pp. 223-227 ◽  
Author(s):  
Julide Canan Umurhan Akkan ◽  
Kemal Tuncer ◽  
Ahmet Elbay
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Macular Edema ◽  
Intraocular Lens ◽  
Cystoid Macular Edema ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Distance Visual Acuity ◽  
Initial Surgery ◽  
The Right

Purpose: To describe a case of cystoid macular edema (CME) developing after posterior chamber toric phakic intraocular lens (PIOL) implantation. Methods: Case report. Results: A 33-year-old male underwent implantation of toric implantable collamer lenses (ICL), a new generation of PIOLs, for both eyes. Preoperative best spectacle-corrected distance visual acuity (BCVA) was 20/25 in the right eye and 20/32 in the left eye, with a manifest refraction of -9.25 -4.0 × 4° and -9.75 -4.25 × 171°, respectively. On day 1 postoperatively, the left eye had an uncorrected distance visual acuity (UDVA) of 20/60 with a refraction of +2.0 -3.5 × 11°. Despite the rotation of the PIOL, the cylindrical refractive component persisted in the left eye with a refraction of +2.0 -3.5 × 11°. Two weeks after the initial surgery, he presented with a decrease in his visual acuity in the left eye. The UDVA and BCVA were both 20/100 in the left eye with a refraction of +2.0 -4.25 × 3°. Dilated fundus examination and macular optical coherence tomography revealed a CME in the left eye. Following topical nepafenac therapy and explantation of the ICL, we observed a complete resolution of the CME at 3 months with an improvement in BCVA to 20/32 in the left eye. Conclusions: To our knowledge, this is the first reported case of postsurgical CME following toric ICL implantation. In cases of phakic eyes with an intact posterior capsule, postsurgical CME can develop, thus highlighting the purpose of this report.

scholarly journals Clinical Course of Pseudophakic Cystoid Macular Edema Treated with Nepafenac

2020 ◽  
Vol 9 (9) ◽  
pp. 3034
Author(s):  
Alexander Aaronson ◽  
Asaf Achiron ◽  
Raimo Tuuminen
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Randomized Clinical Trials ◽  
Clinical Course ◽  
Total Incidence ◽  
Corrected Distance Visual Acuity ◽  
Anti Inflammatory ◽  
Clinically Significant

Background: To evaluate the clinical course of pseudophakic cystoid macular edema (PCME) treated with topical non-steroidal anti-inflammatory drugs (NSAIDs). Methods: An analysis of the clinical course of PCME consisting of 536 eyes of 536 patients from five consecutive randomized clinical trials aimed at the optimization of anti-inflammatory medication in patients undergoing routine cataract surgery. PCME was classified as (i) grade 0a; no macular thickening, (ii) grade 0b; macular thickening (central subfield macular thickness (CSMT) increase of at least 10%) without signs of macular edema, (iii) grade I; subclinical PCME, (iv) grade II; acute PCME, (v) grade III; long-standing PCME. Eyes with PCME classification from grade I onwards were treated with nepafenac 1 mg/mL t.i.d. for two months. Results: CSMT increase of at least 10% at any postoperative timepoint with cystoid changes—a criterion for PCME—was found in 19 of 536 eyes (total incidence 3.5%). Of these 19 eyes, 13 eyes (total incidence 2.4%) had clinically significant PCME. PCME was considered clinically significant when both of the following visual acuity criteria were fulfilled. At any timepoint after the cataract surgery both the corrected distance visual acuity (CDVA) gain was less than 0.4 decimals from that of preoperative CDVA, and the absolute CDVA level remained below 0.8 decimals. Only one of the 19 eyes with criteria for PCME (total incidence 0.2%, incidence of PCME eyes 5.3%) showed no macular edema resolution within 2 months after topical nepafenac administration. Conclusions: PCME in most cases is self-limiting using topical nepafenac without any further need for intravitreal treatment.

Complications of cataract surgery in eyes filled with silicone oil

2018 ◽  
Vol 28 (4) ◽  
pp. 465-468 ◽  
Author(s):  
Piotr Kanclerz ◽  
Andrzej Grzybowski ◽  
Stephen G Schwartz ◽  
Paweł Lipowski
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Silicone Oil ◽  
Open Angle Glaucoma ◽  
Posterior Chamber ◽  
Open Angle ◽  
Intraocular Lens Implantation ◽  
Posterior Chamber Intraocular Lens ◽  
Lens Implantation ◽  
Capsular Rupture

Introduction: The aim of the study was to evaluate complications of cataract surgery in eyes filled with silicone oil. Methods: This retrospective, noncomparative, consecutive case series analyzed medical files of patients with eyes filled with silicone oil undergoing cataract surgery. Phacoemulsification with posterior chamber intraocular lens implantation was conducted with or without concurrent silicone oil removal. Results: In this study, 121 eyes of 120 patients were included. In 32 eyes (26.4%) with evident silicone oil microemulsification or silicone oil–associated open-angle glaucoma, silicone oil was removed prior to phacoemulsification through a pars plana incision and no cases of posterior capsular rupture occurred during the subsequent cataract surgery. In the remaining 89 eyes, phacoemulsification was performed with silicone oil in the vitreous cavity. In these eyes, the rate of posterior capsular rupture was 9/89 (10.1%) and the rate of silicone oil migration into the anterior chamber through an apparently intact posterior capsule was 5/89 (5.6%). In 94 eyes (77.7%), an intraocular lens was inserted into the capsular bag, in 3 eyes (2.5%) into the sulcus, and in 1 eye (0.8%) a transscleral suturing was performed. Conclusions: In this series, complications related to the silicone oil were not uncommon during cataract surgery. In the majority of patients without evident silicone oil microemulsification or silicone oil–associated open-angle glaucoma, cataract surgery and posterior chamber intraocular lens implantation were performed while leaving the silicone oil in place.

scholarly journals Management of Dislocated Intraocular Lenses with Iris Suture

2016 ◽  
Vol 27 (1) ◽  
pp. 45-48 ◽  
Author(s):  
Mun Y. Faria ◽  
Nuno P. Ferreira ◽  
Mario Canastro
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Signs ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Pigment Dispersion ◽  
Corneal Incision ◽  
The Mean

Purpose Subluxated or malpositioned intraocular lenses (IOLs) and inadequate capsular support is a challenge for every ophthalmic surgeon. Iris suture of an IOL seems to be an easy technique for the management of dislocated 3-piece IOL, allowing the IOL to be placed behind the iris, far from the trabecular meshwork and corneal endothelium. The purpose of this study is to assess the results of pars plana vitrectomy (PPV) and iris suture of dislocated 3-piece acrylic IOLs. Methods In this retrospective, nonrandomized, interventional case consecutive study, of a total of 103 dislocated IOLs, 36 eyes were considered for analysis. All 36 eyes had subluxated or totally luxated 3-piece IOL and underwent iris suture at the Ophthalmology Department of Santa Maria Hospital-North Lisbon Hospital Center, Portugal, from January 2011 until November 2015. All patients underwent 3-port 23-G PPV. The optic zone of the dislocated IOL was placed anterior to the iris with the haptics behind, in the posterior chamber. Haptics were sutured to iris followed by placement of the optics behind iris plane. Postoperative measures included best-corrected visual acuity (BCVA), IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and development of macular edema. Results A total of 36 eyes of 36 patients were included. All underwent successful iris fixation of dislocated 3-piece IOL. Mean overall follow-up was 15.9 months (range 3-58 months). At presentation, 16 eyes (44.4%) had a luxated IOL and 20 eyes (55.6%) a subluxated IOL. As underlying cause, 17 eyes (47.2%) had a history of complicated cataract surgery, 5 eyes (13.9%) had a traumatic dislocation of the IOL, and 6 eyes (16.7%) had a previous vitreoretinal surgery. A total of 8 eyes (22.2%) had late spontaneous IOL dislocation after uneventful cataract surgery. The mean preoperative BCVA was 1.09 ± 0.70 logarithm of the minimal angle of resolution (logMAR) units and mean postoperative BCVA was 0.48 ± 0.58 of logMAR units. The mean visual acuity improvement was 4.08 ± 5.33 lines on the logMAR scale. In this study, every IOL was stable at the last follow-up. As late complications, macular edema occurred in 1 patient and retinal detachment occurred in 2 patients. There were no cases of endophthalmitis. Conclusions Iris suture fixation of subluxated IOL is a good treatment option for eyes with dislocated IOLs, leading to long-term stability of the IOL. The advantage of this procedure is using the same IOL in a closed eye surgery. No astigmatic difference is expected as no large corneal incision is needed.

scholarly journals Evaluation of Cystoid Macular Edema Using Optical Coherence Tomography and Fundus Autofluorescence after Uncomplicated Phacoemulsification Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Muhammed Şahin ◽  
Abdullah Kürşat Cingü ◽  
Nilüfer Gözüm
Keyword(s):  
Optical Coherence Tomography ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Fundus Autofluorescence ◽  
Posterior Chamber ◽  
Moderate Increase ◽  
Optical Coherence ◽  
Posterior Chamber Intraocular Lens

Aim. To investigate the utility of fundus autofluorescence (FAF) and optical coherence tomography (OCT) in the evaluation of cystoid macular edema (CME) following cataract surgery.Materials and Methods. Forty eyes of 29 patients undergone phacoemulsification, with posterior chamber intraocular lens implantation surgery. Central macular thickness (CMT) of the patients was evaluated using OCT and FAF preoperatively and postoperative 1st, 30th, 60th, 90th, and 180th days.Results. CME was detected in three eyes (7.5%) of two patients using OCT. Hyperautofluorescence (HAF) was detected in two of these three eyes and resolved with treatment. In the remaining 37 eyes without CME, there was a significant increase in visual acuity when compared to preoperative values () Mean macular thicknesses (MMT) of the eyes without CME were 174 ± 20 μm preoperatively and 179 ± 22 μm at day 1, 178 ± 19 μm at 1st month, and 168 ± 10 μm at 6th month postoperatively. In the eyes with CME, the MMTs, measured with OCT were 189 ± 23 μm preoperatively and 432 ± 361 on day 1, 343 ± 123 μm at 1st month, 345 ± 196 at 2nd month, and 200 ± 36 μm at 6th month postoperatively.Conclusion. We found a moderate increase in CMT in the first 3 months postoperatively, in the eyes without CME which did not cause visual disturbances. FAF is a noninvasive, rapid method for the evaluation and follow-up of CME following cataract surgery.

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