MANAGEMENT OF APHAKIC AND PSEUDOPHAKIC CYSTOID MACULAR EDEMA

Aphakic or pseudophakic cystoid macular edema is an important cause of poor vision after cataract surgery. Its clinical appearance may be subtle with occasional variation, but its angiographic appearance is frequently distinct. Despite advances in cataract extraction, phacoemulsification, scleral-fixated posterior chamber intraocular lenses, and foldable intraocular lenses, pseudophakic cystoid macular edema continues to be a postoperative concern. Parafoveal capillary leakage related to intraocular inflammation is central to the disorder. Local steroid therapy is still a common management strategy. Recent reports demonstrate the effective use of topical cyclo-oxygenase inhibitors in reducing postoperative cystoid macular edema. Proposals to reduce capillary leakage by treatment with grid photocoagulation, hyperoxic exposure, and oral carbonic anhydrase inhibitors are worthy of consideration and are supported by some preliminary data. Unfortunately, no visually significant prophylactic strategy is available.