Sir,

Poor functional visual outcome after successful retinal detachment (RD) repair is mainly owing to photoreceptor cell apoptosis.1 Clinical appearance of the macula in the majority of these patients is normal, but a proportion have anatomical changes observable clinically.2 More recently, ocular coherence tomography (OCT) has helped in revealing residual subfoveal fluid accumulation not visible clinically or on fluorescein angiography,3 more frequent after scleral surgery.4 OCT has also been helpful in showing postoperative cystoid macular oedema (CMO), responsive for the limited visual improvement in a small number of patients. The exact etiopathogenic mechanism of CMO after RD is unclear, but ocular inflammation may play a role, especially after the trauma of cryotherapy, scleral buckle, and subretinal fluid (SRF) drainage. CMO incidence, in phakic eyes, has been reported around 25–30% after cryotherapy and scleral explant,5 and 8% after pneumatic retinopexy.6 It has not been related to preoperative macular status or duration of the RD.7 CMO spontaneous resolution has been described in up to 76% of cases,5 within 2 years postoperatively. Other series, though, report a more bleak evolution of the condition.8 Different treatments have been described, but none with great success. Topical and systemic non-steroidal anti-inflammatory drugs and steroids have been used. There are anecdotic reports of response to acetazolamide.9

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