Bilateral fingolimod-associated macular oedema development after cataract surgery

Area of Science:

• Ophthalmology
• Neurology

Background:

• Postoperative cystoid macular oedema (CMO) is a known complication of cataract surgery, typically managed with topical steroids or NSAIDs.
• The incidence of CMO post-cataract surgery is approximately 1.5%.

Observation:

• A case of bilateral sequential CMO occurred in a patient undergoing bilateral sequential cataract surgery.
• The CMO was unresponsive to topical therapies and worsened after sub-Tenons steroid administration.
• The patient was taking fingolimod for multiple sclerosis prior to and during cataract surgery.

Findings:

• Macular oedema is a known potential side effect of fingolimod.
• Cessation of fingolimod led to the resolution of CMO over 5 months with good visual recovery.

Implications:

• Cataract surgeons should be aware of the risk of fingolimod-associated macular oedema.
• Neurologists may need to adjust fingolimod treatment for patients undergoing cataract surgery.
• This case highlights the importance of medication history in managing postoperative complications.