Cystoid macular edema associated with preservative-free latanoprost after uncomplicated cataract surgery: case report and review of the literature.
BACKGROUND
Cystoid macular edema associated with latanoprost administration has been reported in patients after complicated cataract surgery with coexisting risk factors. We present the first case of preservative free latanoprost associated cystoid macular edema that occurred many months after uncomplicated cataract surgery.


METHODS
A 65-year old Caucasian female presented in the Outpatients Clinic complaining of reduced vision and metamorphopsia in the right eye. She had undergone uneventful phacoemulsification 19 months ago in the right eye and was under treatment with preservative free latanoprost eye drops for the last 7 months for ocular hypertension. Her remaining medical and ocular history were otherwise unremarkable. Cystoid macular edema with serous retinal detachment was diagnosed in the right eye using optical coherence tomography and fluorescein angiography. Latanoprost was discontinued and brinzolamide and nepafenac eye drops were administered in the right eye. Two months later, cystoid macular edema completely resolved with restoration of visual acuity. Nepafenac eye drops were administered for another 2 months. Eight months after latanoprost cessation optical coherence demonstrated no sign of cystoid macular edema whereas a subtle epiretinal membrane was noted.


CONCLUSIONS
Cystoid macular edema may potentially occur in patients receiving preservative free latanoprost. More interestingly, in our case it was diagnosed in a patient with a long standing pseudophakia after uncomplicated phacoemulsification. No obvious risk factor for macular edema development was recognized. Prompt diagnosis and latanoprost discontinuation resulted in complete resolution of the cystoid macular edema and functional restoration of the eye.
Department of Ophthalmology, Medical School, University of Patras, 265 04, Patras, Greece.
Olga E
OE
Makri
Department of Ophthalmology, Medical School, University of Patras, 265 04, Patras, Greece.
Foteini N
FN
Tsapardoni
Department of Ophthalmology, Medical School, University of Patras, 265 04, Patras, Greece.
Panagiotis
P
Plotas
Department of Ophthalmology, Medical School, University of Patras, 265 04, Patras, Greece.
Nikistratos
N
Ifantis
Department of Ophthalmology, 401 General Military Hospital of Athens, Athens, Greece.
Paraskevi T
PT
Xanthopoulou
Department of Ophthalmology, Medical School, University of Patras, 265 04, Patras, Greece. cgeorg@upatras.gr.
Constantine D
http://orcid.org/0000-0002-5646-1370
CD
Georgakopoulos
D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D000077338:Latanoprost; D008269:Macular Edema / Q000139:chemically induced*; D018918:Phacoemulsification; D011461:Prostaglandins F, Synthetic / Q000009:adverse effects*; D012163:Retinal Detachment / Q000139:chemically induced*
D000959:Antihypertensive Agents; D011461:Prostaglandins F, Synthetic; D000077338:Latanoprost
Cystoid macular edema; Latanoprost; Preservative free; Uncomplicated phacoemulsification