Pseudophakic cystoid maculopathy: a study of 50 cases

Abstract

The incidence of clinical cystoid macular edema (CME) in routine cataract surgery is about 2%. Clinically significant pseudophakic maculopathy has a higher incidence and is more severe. Fifty cases of CME following intracapsular cataract extraction and intraocular lens implantation in a series of 821 consecutive cases were reviewed. The overall incidence of pseudophakic cystoid macular edema (PCME) was 6.1%. Several clinical observations were made: (1) Young patients, or those under 65, had a much higher incidence of PCME, approaching 20%; (2) chronic inflammation is responsible for pseudophakic cystoid maculopathy; (3) systemic steroid therapy of CME in the pseudophakic patient was beneficial in 80% of the cases, with a response within ten days; and (4) pseudophakic cystoid maculopathy is almost always recurrent and frequently requires maintenance suppression with daily steroid drops after recovery. Forty-four percent of these patients did not recover better than 20/40 visual acuity, suggesting that CME in the pseudophakic patient is not a benign, self-limited disease.