Purpose:

To report the safety and efficacy of subthreshold micropulse yellow laser of 577 nm for a complex case of refractory pseudophakic cystoid macular edema.

Methods:

A retrospective chart review of an interventional case report of three subthreshold micropulse yellow laser interventions for refractory pseudophakic cystoid macular edema.

Patient:

A 77-year-old healthy female underwent pseudoexfoliative cataract surgery complicated by posterior capsule rupture and sulcus intraocular lens implantation. After 3 months, she required a scleral fixation of the same lens, due to a lack of capsular support and decentration of the intraocular lens. One month later, she experienced a severe pseudophakic cystoid macular edema (foveal thickness of 399 µm and best-corrected visual acuity of 20/80 Snellen). The condition was refractory to conventional treatments prior to subthreshold micropulse yellow laser interventions, including non-steroidal anti-inflammatory eye drops, topical steroids, oral indomethacin and three sub-Tenon’s triamcinolone injections, attempted over a 14-month period.

Results:

Subthreshold micropulse yellow laser treatment was performed and immediate resolution was achieved and maintained for 2 months. Two cases of edema relapse were observed at 3 months from initial laser treatment and again at 4 months from the second laser treatment. Final patient’s follow-up at 6 months from the third laser treatment evidenced the absence of edema, improved visual acuity (foveal thickness of 265 µm/best-corrected visual acuity of 20/30 Snellen) and the absence of complications.

Conclusions:

Subthreshold micropulse yellow laser seems to be a safe and effective treatment for short-term resolution of refractory pseudophakic cystoid macular edema after complicated cataract surgery and represents a useful alternative to expensive and invasive therapies. A trend towards a longer duration of edema resolution with every subthreshold micropulse yellow laser repetition was observed.

中文翻译：

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阈下微脉冲黄色激光治疗复杂白内障手术后难治性黄斑囊样水肿。

目的：

报告 577 nm 亚阈值微脉冲黄色激光治疗难治性假晶状体囊样黄斑水肿复杂病例的安全性和有效性。

方法：

三种阈下微脉冲黄激光治疗难治性假晶状体囊样黄斑水肿的介入病例报告的回顾性图表回顾。

病人：

一名 77 岁健康女性接受假性剥脱性白内障手术并发后囊破裂和沟人工晶状体植入。3 个月后，由于缺乏囊支持和人工晶状体偏心，她需要对同一晶状体进行巩膜固定。一个月后，她出现了严重的假晶状体黄斑囊样水肿（中心凹厚度为 399 µm，最佳矫正视力为 20/80 Snellen）。在尝试了 14 个月的亚阈值微脉冲黄色激光干预之前，这种情况对常规治疗无效，包括非甾体抗炎眼药水、局部类固醇、口服消炎痛和三种 sub-Tenon 曲安西龙注射液。

结果：

进行了亚阈值微脉冲黄色激光治疗，并立即解决并维持了 2 个月。首次激光治疗后 3 个月观察到 2 例水肿复发，第二次激光治疗后 4 个月再次观察到水肿复发。第三次激光治疗后 6 个月的最终患者随访证明没有水肿，视力提高（中心凹厚度为 265 µm/最佳矫正视力为 20/30 Snellen）并且没有并发症。

结论：

亚阈值微脉冲黄色激光似乎是复杂白内障手术后难治性假晶状体黄斑囊样水肿的短期解决安全有效的治疗方法，并且代表了昂贵和侵入性治疗的有用替代方案。观察到随着每个亚阈值微脉冲黄色激光重复，水肿消退持续时间更长的趋势。