Suprachoroidal Triamcinolone Acetonide for Refractory Postoperative Cystoid Macular Edema

Purpose: To investigate outcomes of suprachoroidal triamcinolone acetonide (SCS-TA; XIPERE, Bausch+Lomb) for the treatment of refractory postoperative cystoid macular edema (CME). Methods: Medical records of patients receiving SCS-TA for postoperative CME were reviewed. Primary outcomes were visual acuity (VA) and central foveal thickness (CFT). Results: We included 32 eyes from 32 patients with median (interquartile range, IQR) follow-up duration of 6 (2-7) months and 1 (1-2) SCS-TA injection. 19 (59.4%) had a history of vitrectomy. The median (IQR) CFT decreased from 492 (379-629) µm to 267 (187-388) µm at 1 month (P<0.001), 362 (218-521) µm at 3 months (P=0.005), and 339 (206-514) µm at the final visit (P<0.001). Median logMAR VA improved from 0.65 (0.48-0.97, 20/89) at baseline to 0.54 (0.35-0.88, 20/69) (P=0.058) at 1 month, 0.54 (0.33-0.84, 20/69) at 3 months (P=0.121), and 0.60 (0.33-0.88, 20/80) at the final visit (P=0.021). Vitrectomized eyes had similar findings. Six eyes (18.8%) developed elevated intraocular pressure (IOP) (> 24 mmHg) (range: 25-49 mmHg) with a median IOP elevation of 13.5 mmHg compared to baseline, and all had prior glaucoma or ocular hypertension. Conclusions: SCS-TA reduced macular edema and improved vision in refractory postoperative CME, including vitrectomized eyes. IOP should be monitored, especially in those with a history of glaucoma or ocular hypertension.