Abstract：
Cystoid macular edema (CME) is the most common cause of decreased visual acuity after both vitrectomy and cataract surgery. Various strategies have been used for its treatment, such as intravitreal corticosteroids. The intravitreal fluocinolone acetonide implant (Iluvien®) is approved for the treatment of persisting diabetic macular edema and for the prevention of recurrence of non-infectious uveitis affecting the posterior segment. There are very few reports about its off-label use for post-surgical CME. We present four clinical cases of post-surgical CME (three following vitrectomy and one following cataract surgery in a vitrectomized eye 2 years ago). All of them had been previously treated with an average of four injections of intravitreal dexamethasone implant (Ozurdex®), with repeated recurrence of CME. After treatment with Iluvien, three cases showed improvement of both visual acuity and macular anatomy, with resolution of the macular edema. One patient required additional treatment with Ozurdex during follow-up, further improving CME. Two of the cases required topical pressure lowering treatment, and none required filtering surgery. Iluvien could be an effective therapeutic option for persistent non-diabetic macular edema after vitrectomy or cataract surgery refractory to other intravitreal therapies, with the benefit of being able to provide longer recurrence-free periods.
摘要：
黄斑囊样水肿（CME）是玻璃体切除术和白内障手术后视力下降的最常见原因。已经使用了各种策略来治疗它，如玻璃体内皮质类固醇。玻璃体内氟轻松酮植入物（Iluvien®）被批准用于治疗持续性糖尿病性黄斑水肿和预防影响后段的非感染性葡萄膜炎的复发。关于其用于手术后CME的标签外使用的报道很少。我们介绍了4例术后CME的临床病例（2年前在玻璃体切除术后进行玻璃体切除术后进行了3例，在白内障手术后进行了1例）。所有这些患者之前平均注射了四次玻璃体内地塞米松植入物（Ozurdex®），CME反复复发。用Iluvien治疗后,3例患者视力和黄斑解剖都有改善，黄斑水肿的消退。一名患者在随访期间需要使用Ozurdex进行额外治疗，进一步完善CME。其中两例需要局部降压治疗，也没有人需要做过滤手术.Iluvien可能是其他玻璃体内治疗难治性玻璃体切除术或白内障手术后持续性非糖尿病性黄斑水肿的有效治疗选择。能够提供更长的无复发期。
