• explanation
• treatment
• link: text

Cataract surgery is occasionally followed by this condition (about 1%). Fluid accumulates in the central retina, in the macula area, and the retina thickens like a sponge. This makes the sight blurred, a bit like looking through water. Usually the condition is found at first post-operative visit at 4 weeks, sometimes earlier.

The condition is much more likely to develop in diabetes & complicated cataract surgery.

Macular oedema (purple arrow)..
the central retina becomes
thickened like sponge
enlarge

• Mild cases seen at 2-4 weeks (6/9-6/12 vision) usually settle without treatment

• For most cases, whenthe oedema is seen 1-4 weeks after surgery, the first treatment is dexamethasone & acular drops three times/day for 4 weeks (a steroid..the dexamethasone, and a none-steroidal drug..the Acular,)

• If this is not successful after 4 weeks of the drops, we then offer, at 6-8 weeks post-operation, intravitreal triamcinolone 2mg

• Sometimes laser is needed for the diabetic retinopathy (the macular oedema may be part of the diabetic retinopathy)

• Occasionally vitreous is trapped in the wound and this can be surgically removed or sometimes lasered. Retina 2012

• see Antivegf Arevelo 09.

• Usually there is a significant improvement. Very mild cases do not need treatment; the drops help most others. Very few people need the triamcinolone injection, and it is usually successful when given.

• All patients should be checked for diabetes and keep the blood pressure below 140 systolic (not diabetic), below 130 (if diabetic).

• Prevention: high risk patients (patients with diabetes or complicated surgery, needing iris hooks, posterior capsule rupture) should be examined 2 weeks after surgery, and an OCT carried out if the vision is reduced.