Prophylaxis and therapy of aphakic cystoid macular edema

Aphakic cystoid macular edema (ACME) can be a visually significant complication of modern cataract surgery. Prophylaxis of ACME is preferable to therapy of established ACME. Selection of the appropriate cataract operation, control of systemic factors, avoidance of topical catecholamines, control of intraocular inflammation and use of topical or systemic pharmacologic agents may play a role in the prevention of ACME. If it is proven that light toxicity influences the development of ACME, filters in operating microscopes or in intraocular lenses, cataract glasses, or contact lenses may be helpful. Once ACME is present, antiinflammatory therapy has been the main intervention, although its longterm value remains uncertain. Surgical approaches of unproven value have included photocoagulation, vitrectomy, and removal of an intraocular lens.