Visually significant cystoid macular edema in pseudophakic and aphakic patients with glaucoma receiving latanoprost.
OBJECTIVE
To investigate the incidence of visually significant cystoid macular edema associated with the use of latanoprost in patients with glaucoma after cataract surgery.


METHODS
This is a multicenter, retrospective study of 185 patients, of whom 173 were pseudophakic (212 eyes) and 12 were aphakic (13 eyes), who were treated for glaucoma with latanoprost 0.005%. The posterior lens capsule was intact in 125 eyes, open or absent as a result of surgery in 25 eyes, and status-post-yttrium-aluminum-garnet capsulotomy in 75 eyes. Visual acuity was documented before and after initiating latanoprost therapy, and patients with a reduction of two or more lines on the Snellen chart were examined by fluorescein angiography for cystoid macular edema.


RESULTS
Visual reduction was documented in four (2.16%) patients. Three of the four patients had cystoid macular edema, and the fourth was thought to have lost a central island of vision from glaucoma. The three patients with cystoid macular edema all had ruptured posterior capsules, requiring anterior vitrectomy, and one had a previous episode of cystoid macular edema 3 years before starting latanoprost therapy.


CONCLUSIONS
These findings suggest that visually significant cystoid macular edema associated with latanoprost therapy in pseudophakic or aphakic patients is uncommon. If there is a cause-and-effect relationship between latanoprost therapy and clinically significant cystoid macular edema, the incidence appears to be low.
Lima
M C
MC
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA.
Paranhos
A
A
Salim
S
S
Honkanen
R
R
Devgan
L
L
Wand
M
M
Gaudio
A R
AR
Shields
M B
MB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001036:Aphakia, Postcataract / Q000150:complications*; D002386:Cataract / Q000150:complications*; D002387:Cataract Extraction / Q000009:adverse effects; D002648:Child; D002908:Chronic Disease; D017889:Exfoliation Syndrome / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000187:drug effects; D000077338:Latanoprost; D008269:Macular Edema / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011461:Prostaglandins F, Synthetic / Q000009:adverse effects* / Q000627:therapeutic use; D019591:Pseudophakia / Q000150:complications*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014792:Visual Acuity
D000959:Antihypertensive Agents; D011461:Prostaglandins F, Synthetic; D000077338:Latanoprost