Vitrectomia no tratamento do edema cistóide de mácula pós-pseudofacia

Vitrectomia no tratamento do edema cistóide de mácula pós-pseudofacia


Kátia Emiko Taba,
Antonio Marcelo Barbante Casella,
José Augusto Cardillo,
Ayrton Roberto B. Ramos,
Jeffrey L. Marx,
Lawrence P. Chong


Arquivos Brasileiros de Oftalmologia

versão impressa ISSN 0004-2749versão On-line ISSN 1678-2925

Arq. Bras. Oftalmol. vol.61 no.1 São Paulo fev. 1998



Cystoid macular edema (CME) is one of the leading causes for loss of visual acuity in patients after cataract surgery. The purpose of this study is to evaluate the efficacy of vitrectomy in the treatment of patients with pseudophakic cystoid macular edema who do not have an intact posterior capsule.

Material and methods:

We evaluated retrospectively the medical records of 11 pseudophakic patients with CME who had either removal or rupture of the posterior capsule and underwent vitrectomy for the treatment of CME.


There was a significant visual improvement comparing the pre- and post-operative visual acuities. We did not find a significant difference comparing the subgroups of anterior and posterior intraocular lens.


Pars plana vitrectomy should be considered in the treatment of pseudophakic CME if there is evidence of vitreous traction and it is unresponsive to medical treatment.


1 Cunha SL. Edema cistóide de mácula. In: Bonomo PP, Cunha SL (eds.) - Doenças da mácula. - São Paulo: Roca 1993; p197-203.
2 Fine BS, Brucker AJ. Macular edema and cystoid macular edema. Am J Ophthalmol 1981;92:466-481.
3 Fung WE. Vitrectomy-ACME Study Group. Vitrectomy for chronic aphakic cystoid macular edema: results of a national, collaborative, prospective, randomized investigation. Ophthalmology 1985;92: 1102-11.
4 Gass JDM. Stereoscopic atlas of macular diseases: diagnosis and treatment. 3.ed. St Louis: CV Mosby, 1987. p. 368-82.
5 Gass JDM, Anderson DR, Davis EB. A clinical, fluorescein angiographic, and electron microscopic correlation of cystoid macular edema. Am J Ophthalmol 1985; 100:82-6.
6 Harbour JW, Smiddy WE, Rubsamen PE, Murray TG, Davis JL, Flynn HW. Pars plana vitrectomy for chronic pseudophakic cystoid macular edema. Am J Ophthalmol 1995;120:302-7.
7 Melberg NS, Olk RJ. Corticosteroid-induced ocular hypertension in the treatment of aphakic or pseudophakic cystoid macular edema. Ophthalmology 1993;100:164-7.
8 Miyake K, Shirasawa E, Hikita M. Hypotheses on the role of prostaglandins in the patohogenesis of epinephrine maculopathy and aphakic cystoid macular edema. Prog Clin Biol Res 1989;312:265-76.
9 Miyake K, Tomimatsu PI. Edema cístico de mácula - Aspectos atuais. Arq Bras Oftal 1985;48:206-11.
10 Ruiz RS, Saatci OA. Visual outcome in pseudophakic eyes with clinical cystoid macular edema. Ophthalmic Surg 1991;22:190-3.
11 Schubert HD. Cystoid macular edema: the apparent role of mechanical factors. Prog Clin Biol Res 1989;12:277-91.
12 Tso MOM. Pathology of cystoid macular edema. Ophthalmology 1982;89:902-95.
13 Zimmerman TJ - Textbook of ocular pharmacology. Philadelphia: Lippincott-Raven Publishers 1997; p. 409-15.