What is Pseudophakic Cystoid Macular Oedema?

Pseudophakic Cystoid Macular Oedema (PCMO), is a possible complication of cataract surgery that affects 1-2% of patients. It is caused by fluid leakage and swelling of the macula, which is the central part of the retina and responsible for sharp vision. This swelling creates small pockets of fluid within the retina and usually appears within 3-months after surgery, peaking around 4 to6 weeks. Certain factors increase the risk of developing PCMO, such as complicated cataract surgery, a history of PCMO in the other eye, and diabetes. Patients with PCMO might not notice any symptoms, but some may experience decreased or distorted vision. During an eye exam, the optometrist may see macular thickening, and a yellowish appearance around the macula. These signs are better seen with retinal imaging techniques like Optical Coherence Tomography (OCT), which shows macular thickening and cystic lesions.

How is Pseudophakic Cystoid Macular Oedema managed?

Mild cases often resolve on their own, but if there's no improvement after 4-6 weeks, treatment with eye drops may be needed. This can include steroid eye drops like prednisolone acetate and possibly adding non-steroidal anti-inflammatory drops (NSAIDs) in the early period following surgery. If the condition doesn't improve after six weeks of treatment, an urgent referral to an ophthalmologist (specialist eye doctor) is needed, who may conduct further tests like fluorescein fundus angiography confirm the diagnosis and rule out other conditions. For chronic cases that don’t resolve with eye drops, treatments may include steroid injections or anti-VEGF injections.