Topical three-drug combination in the management of pseudophakic cystoid macular edema

Abstract

The purpose was to report the outcome after usage of three topical eyedrops combination, consisting of one steroid, one carbonic anhydrase inhibitor (CAI), and one non-steroidal anti-inflammatory drug (NSAID) in the treatment of pseudophakic cystoid macula edema (PCME) or Irvine–Gass syndrome. Treatment response monitoring of two patients with PCME to the combination of three eyedrops in a fixed dose regimen done using Optical Coherence Tomography. In both cases, significant improvement was documented within 1 week of starting the treatment, with respect to both visual acuity as well as central macular thickness and intraretinal fluid or cystoid macula edema (CME) resolution. The combination of three topical drugs of difluprednate (steroid), dorzolamide (CAI), and nepafenac (NSAID) is highly effective in treating select cases of pseudophakic CME and negates the need for usage of intravitreal (IVT) or posterior sub-Tenon’s injection of drugs such as triamcinolone acetonide, i.e., IVT triamcinolone acetonide, or posterior subtenon thus avoiding its associated complications.