Título

BILATERAL CYSTOID MACULAR EDEMA AFTER UNILATERAL CATARACT SURGERY - CASE REPORT

Objetivo

This poster aims to report the case of a patient with bilateral CME after unilateral cataract surgery

Métodos

Case report

Resultados

Female patient, 66 years old, with history of glaucoma surgery in both eyes (BE) underwent cataract surgery with intraocular lens implantation. Cataract surgery was performed with intraocular lens implantation (capsular bag) in right eye (RE), without intercurrences. Thirty-three days after the surgery, the patient returned complaining about vision worse. Fluorescein angiography (FA) and macula OCT were performed, confirming bilateral cystoid macular edema (CME). Treatment with Nepafenac was started in RE and, after 3 weeks, a new OCT was performed showing anatomical improvement of macular region in BE, still with residual fluid.
After 3 months of treatment, the patient returned with improvement in BCVA and anatomical improvement on OCT, still with a small residual of subfoveal fluid in the RE

Discussão e Conclusões

The patient developed bilateral CME after unilateral cataract surgery without risk factors.
According to the literature, the occurrence is unilateral, in the same eye in which the cataract surgery was performed. We were not able to find, in the reviewed literature, a situation of bilateral occurrence after unilateral surgery. In CME, the FA presents macular hyperfluorescence in a pentaloid pattern, due to the extravasation of perifoveal capillaries and nerve impregnation, identified in RE. In OCT, cystic images with macular hyporeflectivity and increased thickness are observed in BE.
The treatment of CME initially consists in non-steroidal anti-inflammatory drugs and topical corticosteroids to reduce the inflammatory response induced by prostaglandins. If unsuccessful, intravitreal triamcinolone acetate, dexamethasone implant and, in selected cases, antiangiogenic therapy can be performed. The patient showed a good response to the use of topical NSAIDs, with no need for further interventional measures

Palavras Chave

bilateral CME after unilateral cataract surgery

Área

Clínica