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February 1989

Cystoid Macular Edema Following Cataract Surgery-Reply

Arch Ophthalmol. 1989;107(2):166-167. doi:10.1001/archopht.1989.01070010172004

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In Reply.  —Dr Flach suggests that my estimate of 10 000 new unhappy patients per year (1% of cases) with chronic, visually significant postcataract CME may be an underestimate because the two studies reviewed employed postoperative topical corticosteroid therapy.1,2 While it is possible that routine postoperative use of corticosteroids decreases the incidence of persistent aphakic or pseudophakic CME, we have no definite evidence to support this hypothesis, in regard to either angiographic or visually significant CME.3,4 However, virtually all cataract surgeons in the United States do indeed use a postoperative topical corticosteroid. Many patients are given topical corticosteroids indefinitely. Thus, an estimated rate of persistent, visually significant CME of approximately 1% to 2% seems appropriate.Dr Flach's next point is that the severity of the angiographic CME may not correlate with the patient's visual acuity. In their recently reported study, with small numbers of patients, Flach et al

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Flach AJ, Dolan BJ, Irvine AR:  Effectiveness of ketorolac tromethamine 0.5% ophthalmic solution for chronic aphakic and pseudophakic cystoid macular edema . Am J Ophthalmol 1987;103:479-486.
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