CYSTOID MACULAR EDEMA AFTER FOUR-POINT SCLERAL FIXATION OF INTRAOCULAR LENS. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Hauser, David; Ben-David, David; Masarwa, Dua; Jaar, Richard; Arow, Majd; Haas, Keren; Pokroy, Russell
• Is Part Of: Retina. Volume 41:Issue 10(2021)
• Publication Date: 2021-10
• Subjects: ab externo scleral fixation -- Gore-Tex suture -- intraocular lens -- pseudoexfoliation -- pseudophakic cystoid macular edema -- 4-point scleral fixation; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003142
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To assess the incidence of cystoid macular edema (CME) associated with 4-point Gore-Tex suture intraocular lens (IOL) scleral fixation, before and after institution of routine intravitreal triamcinolone acetonide prophylaxis and long-term topical nonsteroidal anti-inflammatory drug usage. Methods: Consecutive patients were included after IOL implantation with concurrent pars plana vitrectomy for spontaneous IOL dislocation due to pseudoexfoliation syndrome. We compared short-term prophylactic nonsteroidal anti-inflammatory drugs only (Group A) to prophylactic intravitreal triamcinolone acetonide and long-term nonsteroidal anti-inflammatory drugs (Group B). Results: Twenty-six eyes of 26 patients with pseudoexfoliation syndrome and spontaneous IOL dislocation were studied. Mean logMAR visual acuity improved from 1.27 ± 0.80 (20/375 Snellen equivalent) preoperatively to 0.46 ± 0.39 (Snellen 20/43) postoperatively ( P < 0.001). Visual outcomes were similar for Groups A and B. In Group A, 10/16 eyes had CME, 4/16 had chronic CME longer than 6 months, and 1 longer than 12 months. In Group B, 1/10 had CME (which was both chronic and refractory). Conclusion: In eyes with pseudoexfoliation syndrome and spontaneous IOL dislocation, 4-point Gore-Tex suture IOL ab externo fixation yielded good visual outcomes, although CME was observed more than reported elsewhere. Prophylactic intravitreal triamcinolone acetonide and long-term nonsteroidal anti-inflammatory drugs seem to reduce the risk of postoperative CME. Abstract : A retrospective study of 26 patients who underwent 4-point ab externo scleral intraocular lens fixation with Gore-Tex suture for spontaneous intraocular lens dislocation associated with pseudoexfoliation syndrome. All eyes had good visual outcomes. Cystoid macular edema was observed more than reported elsewhere, but less after treatment with prophylactic intravitreal triamcinolone acetonide and long-term nonsteroidal anti-inflammatory drugs than without treatment.