Subthreshold micropulse yellow laser for the management of refractory cystoid macular edema consequent to complicated cataract surgery. Issue 5 (September 2021)

• Record Type: Journal Article
• Authors: Verdina, Tommaso; Ferrari, Cecilia; Valerio, Edoardo; Brombin, Alberto; Lazzerini, Andrea; Mastropasqua, Rodolfo; Cavallini, Gian Maria
• Is Part Of: European journal of ophthalmology. Volume 31:Issue 5(2021)
• Page Start: NP93
• Page End: NP98
• Publication Date: 2021-09
• Subjects: Pseudophakic cystoid macular edema -- micropulse yellow laser -- cataract surgery -- refractory macular edema; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; 617.7005
• DOI: 10.1177/1120672120928008
• Languages: English
• ISSNs: 1120-6721

Abstract

Purpose: To report the safety and efficacy of subthreshold micropulse yellow laser of 577 nm for a complex case of refractory pseudophakic cystoid macular edema. Methods: A retrospective chart review of an interventional case report of three subthreshold micropulse yellow laser interventions for refractory pseudophakic cystoid macular edema. Patient: A 77-year-old healthy female underwent pseudoexfoliative cataract surgery complicated by posterior capsule rupture and sulcus intraocular lens implantation. After 3 months, she required a scleral fixation of the same lens, due to a lack of capsular support and decentration of the intraocular lens. One month later, she experienced a severe pseudophakic cystoid macular edema (foveal thickness of 399 µm and best-corrected visual acuity of 20/80 Snellen). The condition was refractory to conventional treatments prior to subthreshold micropulse yellow laser interventions, including non-steroidal anti-inflammatory eye drops, topical steroids, oral indomethacin and three sub-Tenon's triamcinolone injections, attempted over a 14-month period. Results: Subthreshold micropulse yellow laser treatment was performed and immediate resolution was achieved and maintained for 2 months. Two cases of edema relapse were observed at 3 months from initial laser treatment and again at 4 months from the second laser treatment. Final patient's follow-up at 6 months from the third laser treatment evidenced the absence of edema, improved visual acuity (foveal thickness of 265 µm/best-corrected visual acuity of 20/30 Snellen) and the absence of complications. Conclusions: Subthreshold micropulse yellow laser seems to be a safe and effective treatment for short-term resolution of refractory pseudophakic cystoid macular edema after complicated cataract surgery and represents a useful alternative to expensive and invasive therapies. A trend towards a longer duration of edema resolution with every subthreshold micropulse yellow laser repetition was observed.