Issue 6/2022
P. Manolova, K. Racheva, P. Vassileva
Specialized Eye Hospital for Active Treatment “Acad. Pashev” – Sofia
Abstract
Introduction: Cystoid macular edema after cataract surgery (Irvine Gas syndrome) is a common cause of postoperative decreased vision. Risk factors for its occurrence are: diabetic retinopathy, chronic uveitis, previous vascular accident, as well as prostaglandins as a choice for glaucoma therapy.
Purpose:To present a clinical case of postoperative macular edema after cataract surgery, our behavior and methods of treatment.
Treatment: NSAIDs are a major inhibitor of prostaglandins. It has been shown that the risk of developing Irvine Gas Syndrome is significantly lower in patients who have received NSAIDs before and after surgery. In recent years, the use of corticosteroid drops instead of or in combination with NSAIDs has been discussed. A well-established method of treatment is subtenon application of a corticosteroid. In cases resistant to the above treatment, the method of choice is intravitreal application of corticosteroids and Anti VEGF drugs.
Results: The patient NN is 74 years old, underwent surgery for cataract of the left eye. The operation went without complications and vision after it was improved to 0.7. Two weeks later, the patient complained of pain and irritation in the operated eye. Vision was reduced to 0.5. We performed optical coherence tomography (ОСТ) and found cystoid macular edema. We did not find any risk factors in the patient, except that a more detailed history showed that the patient had not applied the prescribed corticosteroid drops after surgery. Within forty days, three corticosteroid injections were appliedparabulbar and NSAID drops were prescribed for the operated eye. After that, the patient’s vision was improved to 0.9 and there was a restoration of the anatomical structure of the macula, demonstrated by OCT.
Conclusion:Postoperative macular edema is a relatively common and mild complication of cataract surgery. Thanks to OCT, it is fast and comfortable for the patient. The prevention and treatment of the diseaseare topical NSAIDs before and after the operation and corticosteroids parabulbarin more resistant patients.