Six weeks after routine phacoemulsification, a 58-year-old woman reports blurring of vision despite a clear cornea, quiet anterior chamber and clear posterior capsule. Optical coherence tomography shows intraretinal cystoid spaces with foveal thickening. First-line treatment is:
- A Immediate pars plana vitrectomy with internal limiting membrane peeling
- B Topical non-steroidal anti-inflammatory agent combined with a topical corticosteroid ✓
- C Periocular triamcinolone injection as initial therapy in all cases
- D Oral acetazolamide for three months
Correct answer: B. Topical non-steroidal anti-inflammatory agent combined with a topical corticosteroid
Explanation
Irvine-Gass cystoid macular oedema peaks around 4 to 6 weeks after cataract surgery and is managed first with combined topical NSAID and corticosteroid drops, which suppress prostaglandin-mediated breakdown of the blood-retinal barrier. Vitrectomy is reserved for refractory cases, periocular steroid injection is a second-line option, and acetazolamide has no established role in postoperative pseudophakic macular oedema.
Reference: AAO Basic and Clinical Science Course, Section 12: Retina and Vitreous, 2023-2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.