Shakarchi Fatma, Bassett Evelyn, Cooley Ayorinde, Martin Curtis R, Brandenburg Traeson, Dien Isabelle, Ferreira Lisia B, Shelby Christopher, Coleman Wyche T, LoBue Stephen
Ophthalmology, Willis-Knighton Medical Center, Shreveport, USA.
Ophthalmology, LoBue Laser and Eye Medical Center, Murrieta, USA.
Cureus. 2025 Aug 19;17(8):e90493. doi: 10.7759/cureus.90493. eCollection 2025 Aug.
Light-adjustable lenses (LALs) allow for visual acuity (VA) adjustment after cataract surgery, using ultraviolet (UV) light therapy. UV-induced cystoid macular edema (CME) is not well documented. We report the first case of bilateral CME after UV light therapy with LAL. An 81-year-old woman underwent uncomplicated staged bilateral cataract extraction with LAL implantation. Two days after the second UV light adjustment, she had bilateral decreased VA and a new-onset bilateral CME. UV treatments were halted, and she was started on topical nonsteroidal anti-inflammatory drug (NSAID) therapy and prednisolone. CME completely resolved within three weeks following onset. Topical NSAID and prednisone drops were continued until the completion of all light treatments, followed by a slow taper over one month. We hypothesize that UV light can contribute to CME via multiple mechanisms, including UV-activated macromer byproducts, direct UV-induced injury, or ultraviolet B (UVB) disrupting the blood-aqueous barrier. Clinicians should be aware of this complication and maintain a low threshold for deferring light therapy and initiating topical treatment.
光可调人工晶状体（LAL）可在白内障手术后通过紫外线（UV）光疗实现视力（VA）调整。UV诱导的黄斑囊样水肿（CME）的相关记录并不充分。我们报告了首例使用LAL进行UV光疗后发生双侧CME的病例。一名81岁女性接受了分期双侧白内障摘除联合LAL植入手术，手术过程顺利。在第二次UV光调整两天后，她出现双侧视力下降以及新发的双侧CME。停止UV治疗，并开始局部使用非甾体抗炎药（NSAID）和泼尼松龙治疗。CME在发病后三周内完全消退。持续使用局部NSAID和泼尼松龙滴眼液直至所有光治疗结束，随后在一个月内缓慢减量。我们推测UV光可通过多种机制导致CME，包括UV激活大分子单体副产物、直接UV诱导损伤或紫外线B（UVB）破坏血-房水屏障。临床医生应意识到这种并发症，并在推迟光疗和启动局部治疗方面保持较低的阈值。
