Pharmacologic therapy of pseudophakic cystoid macular edema: 2010 update

To review the current management and pharmacologic treatment of pseudophakic cystoid macular edema.

Systematic review of currently accepted treatment modalities for pseudophakic cystoid macular edema. Main outcome measures include visual acuity and retinal thickness measurement by optical coherence tomography.

Optical coherence tomography is used to diagnose and monitor response to therapy. New topical nonsteroidal antiinflammatory drugs have been approved by the Food and Drug Administration for ophthalmic use, and some show promise in the treatment of pseudophakic cystoid macular edema. Other areas of clinical research include the use of anti-vascular endothelial growth factor agents and the addition of intravitreal routes of administration (e.g., corticosteroids, nonsteroidal antiinflammatory drugs, and anti-vascular endothelial growth factor agents). Surgical therapeutic options include Nd:YAG laser for anterior vitreolysis and pars plana vitrectomy for chronic refractory cases.

Surprisingly, few changes have occurred in recent years in the treatment of pseudophakic cystoid macular edema. Placebo-controlled, double-masked, randomized, clinical trials are largely lacking.