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Definition
- Cystoid macular oedema after intraocular surgery
- usually occurs 1-2 months postoperatively
- Usually resolves spontaneously within 3-6 months
- Classification: acute < 6 months vs chronic > 6 months
Management
- Topical therapy NSAID + steroids
- e.g. Nevanac (Nepafenac) 3x1mg/ml or alternatively Nevanac 1x3mg/ml
- e.g. Pred forte (Prednisolone) gtt 4x/d
- Possible regimen:
- 1st month: Nevanac 1x3mg/ml/d + Pred forte gtt. 4x/d
- 2nd month: reduce Pred forte by 1 drop weekly
- 3rd month: only Nevanac, stop when macular oedema is resolved
- In case of persistent macular oedema
- Other treatment options
- Triamcinolone sub-tenon oder intravitreal
- Diamox (Acetazolamide) p.o.
- Intravitreal anti-VEGF
- Ozurdex (Dexamethasone)
- Iluvien (Fluocinolone acetonide)
- Other treatment options
- Comment
- There is no standardised therapy
- Exclusion of other causes (prostaglandin drops, diabetes, venous occlusion, uveitis, AMD, poorly positioned IOL)
Sources
- EyeWiki Irvine-Gass Syndrome
- Kanski’s Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)
- The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Kalla Gervasio MD, Travis Peck MD et al; Lippincott Williams&Wilkins; 8th Edition (2021)