Treatment modalities of pseudophakic cystoid macular edema

Purpose: To evaluate the clinical profile of cystoid macular edema (CME) following cataract extraction and to assess the response to various treatment modalities. Methods: This was a prospective analysis of all patients diagnosed with CME after cataract surgery conducted in the period from July 2018 to July 2019. Patients were divided into three groups based on their degree of visual impairment. Patients whose visual acuity (VA) ranged from 6/6 to 6/18 were allotted Group A and were treated with topical prednisolone acetate 1% and topical ketorolac tromethamine 0.5%. Group B included patients whose VA ranged from 6/24 to 6/36 and were treated with periocular injection of 40 mg triamcinolone acetonide (TA). Patients with VA <6/60 were allotted Group C and were treated with intravitreal injection of 4 mg TA. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and optical coherence tomography (OCT) findings were recorded at 1-month follow-up. Results: A total of 53.3% developed CME in the first 4–6 weeks post-operatively. CME was more common in patients who underwent extracapsular cataract extraction (ECCE). A total of 75% of patients in Group A, 86.36% in Group B and 66.66% in Group C showed complete resolution of CME at 1-month follow-up. The difference between the pre-treatment and post-treatment macular thickness measured by OCT was statistically significant (P < 0.05) for all groups. Conclusion: CME occurring after cataract surgery usually presents within 4–6 weeks of surgery. Topical non-steroidal anti-inflammatory drugs (NSAIDs) and periocular steroids are effective in the management of pseudophakic CME. However, the choice of treatment is individualised to the patient's needs.