Connect
Methyltrexate for CME for steroid responders
I developed persistent CME after cataract surgery and a retina peel of an ERM in 2024. We successfully treated it for a year with steroids before I became extremely steroid responsive. No one wants to do anything with it now (they say there are no options) and the vision in that eye is about 20/150 correctable to 20/100 with glasses. (the IOL was the wrong strength/ mismatched to my eye) EVERYTHING went wrong with this. The other eye still has the cataract and will NEVER be touched unless someone can figure out the first eye. Glaucoma meds could not keep the pressure under control. It was 60 at one point on three glaucoma meds. Is methyltrexate something I should ask about or pursue as a treatment? I read it might be useful injected into the vitreous.
Like
Helpful
HugInterested in more discussions like this? Go to the Eye Conditions Support Group.
Connect
Can you confirm, was CME the result of the wrong IOL or did you have a lens exchange that resulted in CME? I've also heard of CME as the result to yag to treat PCO. Was that the precipitating event?
I developed an ERM in 2020. My vision became noticeably worse in Dec 2023. I had cataract removal with an IOL implanted in June of 2024. The retina surgeon needed the cataract out to see to do the ERM stripping, so we did the cataract first. My vision was quite a bit worse after cataract surgery and I was 2.25 diopters nearsighted instead of .75 diopters nearsighted. The cataract surgeon gave me the impression that it was all the retina. About 10 weeks later, I had the ERM stripped because it was worse than when it was last looked at in 2022 by the retina surgeon. It seemed to take a long time before my vision got better. Everything looked good until they tried to take me off the steroids in Dec 2024. I immediately went into CME. They tried steroids again and we were able to use 2 drops a day to control it until I went into steroid response glaucoma in April or May of 2025. We kept adding glaucoma meds, thought it was under control and then the pressure exploded up to 60 when I was on one drop steroids a day and three glaucoma meds. They tried injecting the tissue around the eye with steroid to avoid the steroid response, but although that cleared the vision, the steroid response came back two months later. I went to Bascom-Palmer hoping for something newer and was told "I can't help you" right after the Dr. looked at the images he took of my eye - no history even looked at. He was incorrect in saying the ERM surgery was unsuccessful and it was growing back. So far there is no posterior capsular opacification. The retina doctor said my only options were to leave it be or try a tube implant to reduce the pressure when I use steroids. The glaucoma doctor says that the "tube implants" don't work reliably well in all patients and the Dr. at Bascom Palmer said don't try them because they are too problematic. I refused to have the cataract removed on the second eye. Other than a slight color shift to "warm white", and needing more illumination, that eye still sees well.