Macular Edema After Cataract Surgery
Macular odema is an accumulation of fluid in part of the retina called the Macula. This part is responsible for central vision, high visual acuity and color vision.
Sometimes after cataract eye surgery this area will accumulate fluid which leads to blurring of vision for few days and sometimes for weeks and months. Macular odema that occur after cataract surgery will be called Irvine-Gass syndrome.
There are also many diseases that can cause macular edema such as Age related Macular Degeneration, Diabetic Retinopathy, Retinitis Pigmentosa, Central and Branch retinal Vein Occlusions.
This complication can be diagnosed clinically, by the use of OCT and FFA (Fluorescein Angiography). On OCT there is increase in macular thickness due to accumulation of fluid within retinal layers. In FFA there is leakage of fluorescein dye from blood vessels in macular area.
These are risk factors which will increase the incidence of it:
1- Diabetic patients.
2- Rupture of the posterior capsule of the natural lens with vitreous loss during complicated cataract eye surgery.
3- Eye drops or injections which have adrenaline as a component.
Treatment of Macular Edema after cataract eye surgery
1- Observation in which it will resolve by itself. Observation should be done for few weeks in which during this period improvement in visual acuity, OCT thickness and FFA.
2- NSAIDs Eye Drops such as Voltaren Ophtha before and after the surgery can be given for high risk patients.
3- Laser photo-coagulation can be given to the macula to the areas of leakage. This Laser helps to decrease the amount of leaking fluid. but usually this is not the first line of treatment. Sometimes in diabetic patient who is at high risk for post operation retinal edema, laser photo-coagulation can be given before surgery.
4- Corticosteroid either by Corticosteroid Eye drops or by ocular steroid injection. Ocular injection can be either around the globe (periocular injection) or intraocular (Intravitreal injection). Intra Ocular Steroid injection can be given alone or with a combination of Anti-VEGF which is also very helpful to reduce Macular thickness and fluid collection.
5- New treatment for Macular odema with Nanoparticles.