CME following cataract surgery with trifocal IOL

 CME following cataract surgery with trifocal IOL

Zuzana Konecna

Gemini Eye Clinic, Vyskov, CZ


Case report:
Our patient was 55 years old woman, who came to our clinic due to impair ed visual acuity and the cataract of both eyes was diagnosed. The cataract surgery was performed on both eyes with trifocal IOL implantation in November and December 2019 and postoper ative process was uncomplicated. 2 months later, the patient came because of impaired visual acuity in both eyes. The bilateral postoperative CMO was diagnosed by using OCT imaging and topic NSAIDs and Aescin was recommended. With conservative therapy, the oedema was reduced , and visual acuity improved which is still stable.

Cystoid macular oedema after cataract surgery (pseudofakic CMO) is defined as a transient thickening of the macula after cataract surgery. The incidence of PCMO with contemporary surgical techniques of phacoemulsification surgery decreases significantly, during uncomplicated phacoemulsification the incidence has been reported between 4 - 11 %, the incidence of clinical PCMO has been reported at lower rates between 0.1 - 2. 3 %. CMO can also be a complication of various eye diseases – eg. diabetic retinopathy, retinal vein occlusion or intraocular inflammation. The general symptoms of PCMO are blurred vision, loss of contrast sensitivity and metamorphopsia. The diagnosis is d etermineted by the slit‐lamp biomicroscopy , Amsler chart, OCT imaging and FAG. In the treatment of PCMO we could use topical or systemic NSAID, Aescin, carbonic anhydrase inhibitors, anti - VEGF agents or corticosteroids.

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Pavel Stodulka
27. 3. 2021 17:25

CMO is still somehow understimated and overlooked complication of cataract surgery. I routinely apply triamcinolon into the vitreous trans-zonularly at the end of all my cataract cases. This significantly lowers the risk of CMO.