Hyaluronidase is not an essential adjuvant for peribulbar block for cataract surgeries. Appropriate deposition of a smaller volume of anesthetic agent and adequate ocular massage provide adequate and safe anesthesia.
We present a case series of late-onset Pseudophakic cystoid macular edema who presented 10 years to 4 years after cataract surgery with recent-onset diminution of vision. Their vision in the affected eye ranged from 6/24 with an OCT macular map showing multiple cystoid spaces suggestive of cystoid macular edema. Other causes for CME were ruled out. The central macular thickness ranged from 577 to 557 microns. All the patients received a single dose of 0.1ml of 4mg/ml intravitreal triamcinolone acetonide. On the first postprocedure day, all the patient's visual acuity had improved to 6/6 and OCT showed a significant reduction in central macular thickness to 387-301 microns. This improvement in vision and macular thickness persisted at 3 months follow up. Late-onset of pseudophakic cystoid macular edema is a rare cause of postoperative vision loss, economically and easily treatable with a single dose of intravitreal triamcinolone.
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