الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Pseudophakic cystoid macular edema (PCME), also known as Irvine–Gass syndrome, is the most common cause of unexpected visual loss after cataract surgery.
The proposed risk factors for aphakic or pseudophakic CME include hypotony, inflammation, phototoxicity, and vitreous traction. Prostaglandins have been studied as a potential causative factor for CME following cataract/intraocular lens surgery.
Additionally eyes with diabetic maculopathy have a higher risk of developing PCME as well as eyes with uveitis, retinal vein occlusion, epiretinal membrane or eyes using prostaglandin analogues.
Optical Coherence Tomography (OCT) has become widely adopted and allows convenient monitoring of disease activity. A central subfield thickness (CSF) of 315 µm is described as the upper limit for macular thickness measurements by Spectralis Spectral Domain-OCT
PCME is characterized by loss of the foveal depression, retinal thickening, and cystic hyporeflective lesions. OCT also allows the detection of vitreoretinal traction and lamellar holes
There is currently no standardized treatment or prophylactic protocol for PCME, because well designed large RCTs with long-term follow-up are lacking. Topical NSAIDs and topical corticosteroids are nevertheless first-line modalities
This study included 65 eyes of 52 patients with no evident risk factor of PCME undergoing phacoemulsification cataract surgery assigned to 3 groups according to the type of postoperative anti-inflammatory treatment regimen used, group A received postoperative topical NSAIDs with topical steroid eye drops, group B received only postoperative steroid eye drops and group C received single immediately postoperative subconjunctival injection of 0.5 mL (20 mg) triamcinolone acetonide.
Patients were evaluated at 2 week and 6 weeks postoperatively as regard central macular thickness by OCT, decimal BCVA and IOP.
Changes of central macular thickness on OCT in 3 periods (from preoperatively to 2 weeks postoperatively, from 2 to 6 weeks postoperatively and from preoperatively to 6 weeks postoperatively) were lower in group A than in group B and C, however they are not statistically significant.
During the study, 4 patients (6.15%) developed PCME according to cutoff value of 315 µm central macular thickness. Those patients were given topical NSAIDs, if not added to their regimen with short course of oral CAI in addition to topical steroid eyedrops, and followed up clinically and by OCT, all of them showed marked improvement.
Additionally, correlations between central macular thickness changes and different preoperative and operative parameters including age, sex, relevant systemic diseases, cataract density, surgeon factor and phaco machine used, were assessed during the 6-weeks follow-up period and found to be not statistically significant
Also, there were no statistically significant differences between the 3 groups as regards improvement of BCVA or reduction of IOP.
However there were statistically significant differences between different periods where increase in central macular thickness was higher at 6-week follow up than at 2-week follow up in all of the