macula edema

[mike230]

Dear Dr. Hagan,

Had the exam and all those symptoms of dry eye and secondary cataract revealed I have  a little swelling of the cornea (macula edema)  Extensive testing and pictures were taken to rule out any damage to the retina and macula

I am being treated with predforte and aculari  1 drop 4X per day.  Insurance does not cover aculari so  pharmacist said to use nevanac which is compatible to aculari.  Cause of macula edema or retinal swelling can occur to anyone after cataract surgery and it could possibly show up 10 to 15 years later is what the treating retina specialist told me.  Currently my vision is 20/70 and the doctor said when the swelling goes away then the vision should return to where it needs to be.  

Is there anything else that you could share with me about this?  Thanks again

[mike230]

Thanks again
mike230

[John C Hagan III, MD, FACS, FAAO]

none really they are both non-steroidal antiinflammatory drops. Acular was the first one. Nevanac is the newest.

JCH MD

[mike230]

Thanks again for the information I will definitely keep this in mind.  If it goes to the injection route, the attempt would be to inject from under the bottom eye lid.  I was diagnosed with the early stage, so do you think the drop treatment will do the trick?

What is the difference between acular and nevanac?
mike230

[John C Hagan III, MD, FACS, FAAO]

Good luck. Recently Avastin and Lucentis have been used with some success for macular edema. Discuss that if it comes to an injection.

JCH MD

[mike230]

Thanks for sharing that with me

[John C Hagan III, MD, FACS, FAAO]

Personally I would persist with the drops for 6-8 weeks. The injection carries significant risks: infection, bleeding, retinal detachment and especially steroid glauccoma and cataracts.

JCH MD

[mike230]

It is swelling of the retina (macular edema).  The extensive testing revealed no blockages.  Do the predforte and acular (nevanac) treatment work,  The next step would be the injection.

I heard the steroid?? injection works quickly and effectively  My vision had dropped from 20/20 to 20/70 been on the drops for 1 day now.  

Question: the swelling was caught in the early stage and to get this ordeal over with, should I have the opthamologist proceed with the injection.

When I had swelling in my shoulder area 3 years ago, medicines took forever but when I had the injection it cleared it up completely within 3 days
Thanks Dr. Hagan
mike230

[John C Hagan III, MD, FACS, FAAO]

You have your terms wrong cornea edema is totally different than macular edema.

I suspect you have macular edema. Its very unusual to develop 15 years after cataract surgery.  It can occur after yag capsulotomy for secondary cataract. It can also be due to diabetes, injury, blockage of retinal veins.

JCH MD