Pseudophakic macular edema in a steroid responder treated successfully with intravitreal methotrexate: A case report

Pseudophakic macular edema (PME) is typically treated with nonsteroidal anti-inflammatory drugs (NSAIDs) initially, followed by steroids. Treatment with steroids becomes challenging in steroid responders. We report a case of PME treated with intravitreal methotrexate (Mtx) in a steroid responder. A 54-year-old-male underwent anterior vitrectomy with secondary intraocular-lens implantation following an eventful cataract surgery. Topical steroids given as a postoperative regimen led to severe steroid response and therefore were replaced by NSAIDs. Intraocular pressure was controlled by antiglaucoma drugs. Furthermore, he developed cystoid macular edema (CME). Since steroids were contraindicated, he was administered two intravitreal injections of Mtx 15 days apart, resulting in resolution of CME and restoration of vision.