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Joao Guilherme Aguirre, Alessandro J R Dare; Micropulse Laser Therapy For The Treatment Of Longstanding Refractory Pseudophakic Cystoid Macular Edema. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6356.
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© ARVO (1962-2015); The Authors (2016-present)
To report the functional and anatomic outcomes of a new therapeutic possibility using micropulse laser therapy (MLT) for the treatment of longstanding refractory pseudophakic cystoid macular edema (PCME).
Five eyes of four patients with PCME with duration longer than 12 months refractory to topical nonsteroidal anti-inflammatory drugs or topical corticosteroids, unsuccessfully treated with subtenon triamcinolone or intravitreal bevacizumab were subjected to high density micropulse laser therapy involving the macular area. Main outcomes were change in ETDRS best correct visual acuity (BCVA) and central macular thickness (CMT) measured using optical coherence tomography. Patients were followed 1, 2, 3, and 6-months after treatment. Pre and post-treatment fluorescein angiography (FA) were assessed.
No visible clinical signs of treatment could be detected either on fundus examination or FA. By 6 months of follow-up there were full resolution of the macular edema and restoration of the foveal depression in 4 of the 5 patients. BCVA changed from 0,87 ± 0,12 logMAR to 0,62 ± 0,23 logMAR (mean ± SD) and CMT from 632 ± 86 μm to 378 ± 88 μm (mean ± SD). No complication was related to the procedure.
Chronic PCME is traditionally a difficult condition to treat, but we are encouraged by the optimal response experienced with micropulse laser therapy in these patients whose longstanding PCME had been refractory to previous treatments with both subtenon triamcinolone and intravitreal bevacizumab.
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