Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review

<b>Background/Objectives:</b> Cystoid macular edema (CMO) is a common complication that follows cataract surgery, presenting management challenges due to the lack of standardized treatment guidelines and the potential for spontaneous resolution. This study aimed to evaluate various treat...

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Main Authors: Lorenzo Ferro Desideri, Kirupakaran Arun, Enrico Bernardi, Nicola Sagurski, Rodrigo Anguita
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/6/667
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author Lorenzo Ferro Desideri
Kirupakaran Arun
Enrico Bernardi
Nicola Sagurski
Rodrigo Anguita
author_facet Lorenzo Ferro Desideri
Kirupakaran Arun
Enrico Bernardi
Nicola Sagurski
Rodrigo Anguita
author_sort Lorenzo Ferro Desideri
collection DOAJ
description <b>Background/Objectives:</b> Cystoid macular edema (CMO) is a common complication that follows cataract surgery, presenting management challenges due to the lack of standardized treatment guidelines and the potential for spontaneous resolution. This study aimed to evaluate various treatment modalities for post-operative CMO, including topical non-steroidal anti-inflammatory drugs (NSAIDs), periocular steroids, and intravitreal injections. <b>Methods:</b> A systematic review of the literature was conducted to assess the efficacy of different treatment approaches for post-operative CMO. Studies evaluating topical NSAIDs, periocular steroids, intravitreal triamcinolone acetonide (TCA), dexamethasone implants (Ozurdex), and intravitreal bevacizumab were included. The main outcomes assessed included improvements in vision, resolution of CMO, recurrence rates, and safety profile. <b>Results:</b> Topical NSAIDs, particularly ketorolac and diclofenac, showed effectiveness in acute CMO, while their efficacy in chronic cases was variable. Periocular steroids, including retrobulbar TCA and sub-Tenon injections, demonstrated significant improvements in vision and the resolution of CMO, especially in cases resistant to topical therapy. Intravitreal TCA and dexamethasone implants exhibited variable effects on CMO resolution and recurrence rates, with some studies reporting sustained improvements over 12 months. The role of intravitreal bevacizumab as initial therapy remains unclear, although it may be considered in cases unresponsive to steroids. <b>Conclusions:</b> Topical NSAIDs, often combined with periocular steroids, serve as first-line therapy, with periocular steroids offering additional efficacy in resistant cases. Further research is needed to establish optimal treatment algorithms and improve outcomes for patients with post-operative CMO
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spelling doaj-art-9afcda0b21594f8486d4b6ebf86516c22025-08-20T03:43:36ZengMDPI AGDiagnostics2075-44182025-03-0115666710.3390/diagnostics15060667Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic ReviewLorenzo Ferro Desideri0Kirupakaran Arun1Enrico Bernardi2Nicola Sagurski3Rodrigo Anguita4Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH-3010 Bern, SwitzerlandMoorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UKDepartment of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH-3010 Bern, SwitzerlandDepartment of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH-3010 Bern, SwitzerlandDepartment of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH-3010 Bern, Switzerland<b>Background/Objectives:</b> Cystoid macular edema (CMO) is a common complication that follows cataract surgery, presenting management challenges due to the lack of standardized treatment guidelines and the potential for spontaneous resolution. This study aimed to evaluate various treatment modalities for post-operative CMO, including topical non-steroidal anti-inflammatory drugs (NSAIDs), periocular steroids, and intravitreal injections. <b>Methods:</b> A systematic review of the literature was conducted to assess the efficacy of different treatment approaches for post-operative CMO. Studies evaluating topical NSAIDs, periocular steroids, intravitreal triamcinolone acetonide (TCA), dexamethasone implants (Ozurdex), and intravitreal bevacizumab were included. The main outcomes assessed included improvements in vision, resolution of CMO, recurrence rates, and safety profile. <b>Results:</b> Topical NSAIDs, particularly ketorolac and diclofenac, showed effectiveness in acute CMO, while their efficacy in chronic cases was variable. Periocular steroids, including retrobulbar TCA and sub-Tenon injections, demonstrated significant improvements in vision and the resolution of CMO, especially in cases resistant to topical therapy. Intravitreal TCA and dexamethasone implants exhibited variable effects on CMO resolution and recurrence rates, with some studies reporting sustained improvements over 12 months. The role of intravitreal bevacizumab as initial therapy remains unclear, although it may be considered in cases unresponsive to steroids. <b>Conclusions:</b> Topical NSAIDs, often combined with periocular steroids, serve as first-line therapy, with periocular steroids offering additional efficacy in resistant cases. Further research is needed to establish optimal treatment algorithms and improve outcomes for patients with post-operative CMOhttps://www.mdpi.com/2075-4418/15/6/667cystoid macular edemapostoperative edemaIrvine–Gass syndromepseudophakic
spellingShingle Lorenzo Ferro Desideri
Kirupakaran Arun
Enrico Bernardi
Nicola Sagurski
Rodrigo Anguita
Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review
Diagnostics
cystoid macular edema
postoperative edema
Irvine–Gass syndrome
pseudophakic
title Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review
title_full Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review
title_fullStr Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review
title_full_unstemmed Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review
title_short Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review
title_sort incidence pathogenesis risk factors and treatment of cystoid macula oedema following cataract surgery a systematic review
topic cystoid macular edema
postoperative edema
Irvine–Gass syndrome
pseudophakic
url https://www.mdpi.com/2075-4418/15/6/667
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