Posterior Subtenon Injection of Triamcinolone Acetonide after Phacoemulsification in a Patient with X-Linked Retinoschisis

Abstract

To describe a case of X-linked retinoschisis with pseudophakic cystoid macular edema treated by posterior subtenon injection of triamcinolone acetonide. The patient was a 60-year-old man. His best-corrected visual acuity (BCVA) was counting fingers in the right eye. Senile cataract was found with grade II nuclear sclerosis. Optical coherence tomography revealed foveoschisis with a central foveal thickness (CFT) of 545 μm. The patient underwent uneventful phacoemulsification and in-the-bag implantation of intraocular lens. Postoperative persistent cystoid macular edema was found, with CFT increased to 787 μm. The macular edema did not respond to topical corticosteroids and nonsteroidal anti-inflammatory drugs. Triamcinolone acetonide 20 mg was injected into the posterior subtenon space 10 weeks after the surgery. Macular cystic lesions dramatically disappeared 2 months after the injection, and CFT decreased to 171 μm, with accompanying inner/outer segment disruption. His BCVA also improved to 20/100. Macular edema or foveoschisis did not recur, and BCVA remained stable 1 year after the cataract operation. Foveoschisis and pseudophakic cystoid macular edema disappeared after posterior subtenon injection of triamcinolone acetonide without recurrence during the 15-month follow-up period.