Irvine-Gass Syndrome Personalized Treatment Outcomes: A Retrospective Single-Center Cohort Study

Irvine-Gass syndrome (IGS) is a macular edema that is mostly observed after cataract surgery, also known as pseudophakic cystoid macular edema (PCME). To date, there are still no standardized guidelines for its treatment. Background/Objectives: This study aimed to compare the efficacy of local and systemic treatments on the resolution of Irvine-Gass Syndrome as well as the therapeutic outcomes of patients with known risk factors such as diabetes and arterial hypertension in order to be able to personalize treatment regimens for each patient. Methods: A total of 136 eyes were followed for a mean of 9.7 ± 15.2 months, with patients divided as follows: those who received only local treatment (LT), those who received systemic treatment (ST), those with cardiovascular diseases (CV), and those without cardiovascular diseases (NCV). We compared the time from the diagnosis of IGS to fully recovered edema (no sub- or intraretinal fluid), central subfield thickness (CST, as evaluated using optical coherence tomography), visual acuity (VA), and intraocular pressure (IOD) in each group. The time from diagnosis to resolution was measured from the initiation of therapy to the full resolution of edema. Results: A total of 136 eyes were examined. The mean CST significantly decreased in the LT (n = 75) (458.3 ± 96.5 µm to 320 ± 39.5 µm (p < 0.01)) and ST (n = 61) groups (519.3 ± 121.6 µm to 337.2 ± 70.6 µm (p < 0.01)) from baseline to 12 months, with no significant difference (p = 0.92). The mean VA significantly increased in both groups from baseline to 12 months (LT: 69.1 ± 11.9 to 80.4 ± 6.6 letters (p < 0.01); ST: 65.1 ± 11.8 to 78.5 ± 6.8 letters (p < 0.01)). The mean time to the resolution of edema was significantly shorter in the LT group (p < 0.05). There were no significant differences in the CST decrease, VA gain, or time to edema resolution between the CV and NCV patients. Conclusions: In regard to the non-inferiority of local treatment, a personalized approach for each patient should be considered, and systemic treatment must be critically evaluated to determine possible side effects.