To report clinically symptomatic and angiographically documented cystoid macular edema (CME) associated with the use of latanoprost in two pseudophakic eyes after uncomplicated cataract surgery.
Methods
Retrospective review of two patients who had history of latanoprost use and uncomplicated cataract surgery and described blurred vision in the first postoperative month.
Results
Ocular examination revealed CME, which was confirmed by fluorescein angiography. The visual acuities of patients improved and the CME was angiographically resolved after discontinuation of latanoprost and the initiation of nonsteroidal anti-inflammatory eye-drops and oral acetazolamide.
Conclusions
Until a causal relationship between CME and latanoprost is proved or disproved, caution in its use in pseudophakic patients would be prudent.
LindseyJ.D., KashiwagiK., KashiwagiF., WeinrebR.N.Prostaglandin action on ciliary smooth muscle extracellular matrix metabolism: implications for uveascleral outflow. Surv Ophthalmol1997; 41(Suppl): S53–9.
2.
TorisC.B., CamrasC.B., YablonskiM.E.Effects of PhXA41, a new prostaglandin F2a analog, on aqueous humor dynamics in human eyes. Ophthalmology1993; 100: 1297–304.
3.
NilssonS.F.E., SamuelssonM., BillA., StjernschantzJ.Increased uveascleral outflow as a possible mechanism of ocular hypertension caused by prostaglandin F2a-1-isopropylester in the cynomolgus monkey. Exp Eye Res1989; 48: 707–16.
4.
GabeltB.T., KaufmanP.L.Prostaglandin F2a increase uveascleral outflow in the cynomolgus monkey. Exp Eye Res1989; 49: 389–402.
5.
MiyakeK., OtaI., MaekuboK., IchihashiS., MiyakeS.Latanoprost accelerates disruption of the blood-aqueous barrier and the incidence of angiographic cystoid macular edema in early postoperative pseudophakias. Arch Ophthalmol1999; 117: 34–40.
6.
RoweJ.A., HattenhauerM.G., HermanD.C.Adverse side effects associated with latanoprost. Am J Ophthalmol1997; 124: 683–5.
7.
WarmarR.E., BullockJ.D., BallalD.Cystoid macular edema and anterior uveitis associated with latanoprost use; experience and incidence in a retrospective review of 94 patients. Ophthalmology1998; 105: 263–8.
8.
AvakianA., Anderson RenierS., ButlerP.J.Adverse effects of latanoprost on patients with medically resistant glaucoma. Arch Ophthalmol1998; 116: 679–80.
AyyalaR.S., CruzD.A., MargoC.E.Cystoid macular edema associated with latanoprost in aphakic and pseudophakic eyes. Am J Ophthalmol1998; 126: 602–4.
12.
MoroiS.E., GottfredsdottirM.S., SchteingartM.T.Cystoid macular edema associated with latanoprost therapy in a case series of patients with glaucoma and ocular hypertension. Ophthalmology1999; 106: 1024–9.
13.
SchumerR.A., CamrasC.B., MandahlA.K.Latanoprost and cystoid macular edema: is there a causal relation?Curr Opin Ophthalmol2000; 11: 94–100.
14.
WandM., GaudioA., ShieldsB.Latanoprost and cystoid macular edema in high-risk aphakic or pseudophakic eyes. J Cataract Refract Surg2001; 27: 1397–401.
15.
TokunagaT., KashiwagiK., SaitoJ.A case of cystoid macular edema associated with latanoprost ophthalmic solution. Jpn J Ophthalmol2002; 46: 656–9.
16.
WatanabeK., HayasakaS., HayasakaY., NagakiY., WatanabeK.Cystoid macular edema associated with latanoprost use in a pseudophakic eye with a history of surgical complications. Jpn J Ophthalmol2003; 47: 110–2.
17.
JägerM., JonasJ.B.Cystoid macular edema associated with latanoprost therapy in a pseudophakic vitrectomized patient after removal of silicone oil endotamponade. Eur J Ophthalmol2003; 13: 221–3.
18.
YehP.C., RamanathanS.Latanoprost and clinically significant cystoid macular edema after uneventful phacoemulsification with intraocular lens implantation. J Cataract Refract Surg2002; 28: 1814–8.
19.
MiyakeK., OtaI., IbarakiN.Enhanced disruption of the blood-aqueous barrier and the incidence of angiographic cystoid macular edema by topical timolol and its preservative in early postoperative pseudophakia. Arch Ophthalmol2001; 119: 387–94.
