First Author: A.Lula ALBANIA
Co Author(s): A. Lula
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To report that postoperative macular oedema is still a clinical problem, indicating that close observation of patients undergoing cataract surgery is required. Dexamethasone implants might be an extremely effective option in the treatment of refractory cases of this condition.
University Hospital Centre “Mother Theresa”, Department of Ophthalmology, Tirana, Albania
This is a case report of a patient diagnosed with postoperative macular oedema in both eyes, treated with intra-vitreal dexamethasone implants after failed first-line therapy (NSAID and Acetazolamide) and followed-up for 12 months. The diagnosis was based on visual acuity, clinical features of this condition, OCT and fluoresceine angiography (FFA) results.
The application of topical NSAID and Acetazolamide resulted in a minimal reduction of macular oedema. On the contrary, treatment with Dexamethasone implants showed extremely effective results, reducing macular oedema (based on central retinal thickness CRT) to normal values within 45 days in both eyes (CRT was reduced from 763μm to 187μm in the right eye OD and from 751μm to 165μm in the left eye OS). Visual acuity returned to 6/6, 60 days after the Ozurdex® injection.
Dexamethasone implants (Ozurdex®) should be considered as an effective alternative for the treatment of postoperative macular oedema (Irvin-Gass Syndrome), especially in refractory cases with severe reduction in visual acuity and very high values of central retinal thickness (CRT). Close observation of these patients is required to reduce the risk of vision loss and prevent permanent damage of visual function due to changes in the multi-layer structure of neuro-sensory retina NRR and retinal pigment epithelium RPE caused by a large postoperative macular oedema.