International Journal of Clinical and Experimental Ophthalmology Open Access HTTPS://WWW.HEIGHPUBS.ORG 001 ISSN 2577-140X Abstract Irvine-Gass syndrome, is one of the most common causes of painless decrease in vision following even uneventful cataract surgery. It usually responds well to medical therapy, but, there are no widely acceptedconsensus on the efficacy of various therapeutic options for the treatment of Irvine-Gass syndrome. The patient presenting in this case report, has systemic hypertension and chronic obstructive pulmonary disease and he use oral anti-hypertension medication and inhaler steroid. He diagnosed as Irvine-Gass syndrome due to presence of decrease in visual acuity and macular edema with hyporeflective cystic intraretinal spaces in optical coherence tomography (OCT) since4th weekcontrol visitfollowing uneventful cataract surgery. After the responsiveness of several medications including topical steroid and non-steroidal anti-inflammatory drugs and intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF), intravitreal sustained- release dexamethasone implant was applied. The visual acuity improved to 0.00 logMAR at 1st month after intravitreal dexamethasone therapy and consecutive OCT images showed complete resolution of macular edema with a normalization of the foveal profile.The visual acuity and foveal architecture remained stable in 2-year follow-up period and additional treatment was not needed. To the best of our knowledge, this is the first reportthatmentions the increment of visual acuity after a single dexamethasone implant, even though it did not response anti-VEGF combined with topical steroid and non-steroidal anti-inflammatory drugs. Case Report The management of Irvine-Gass Syndrome in a patient using Inhaler Steroid Ayse Gul Kocak Altintas 1 *, Cagri Ilhan 2 and Mehmet Citirik 1 1 MD, Associated Professor, University of Health Sciences, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey 2 MD, Hatay State Hospital, Hatay, Turkey *Address for Correspondence: Ayse Gul Kocak Altintas, MD, Associated Professor, University of Health Sciences, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey, Tel: 90-312-3126261; Fax: 90-312-3124827; Email: aysegulkaltintas@hotmail.com Submitted: 02 February 2018 Approved: 06 February 2018 Published: 07 February 2018 Copyright: 2018 Altintas AGK, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited Keywords: Cystoid macular edema; Irvine-Gass syndrome; Dexamethasone implant How to cite this article: Altintas AGK, Ilhan C, Citirik M. The management of Irvine-Gass Syndrome in a patient using Inhaler Steroid. Int J Clin Exp Ophthalmol. 2018; 2: 001-005. https://doi.org/10.29328/journal.ijceo.1001011 Introduction Pseudophakic cystoid macular edema (CME) also known as Irvine-Gass syndrome, is one of the most common cause of painless decrease in vision following even uneventful cataract surgery [1]. The pathogenesis of this syndrome reported to be multifactorial. Its incidence is higher in patients with vasculopathy, hypertension, uveitis [2-4]. Irvine- Gass syndrome is usually self-limiting and spontaneous resolution occurs within 3-6 months [5]. But in some cases, it persists for more than 6 months and considered as chronic pseudophakic CME [6,7]. Even it usually responds well to medical therapy, still there are no widely acceptedconsensus on the efϐicacy of various therapeutic options for the treatment of Irvine-Gass syndrome. Topical/periocular corticosteroids and intravitreal anti-vascular endothelial growth factor (anti-VEGF) are potent anti-inϐlammatory agents that can inhibit development of Irvine-Gass syndrome. Intravitreal sustained-release steroid implants can be effective in recalcitrant cases by its high potential anti-inϐlammatory and anti-edema effect [8,9]. In this case report, we presented an Irvine-Gass syndrome using inhaler steroid, treated by intravitreal sustained-release dexamethasone implant that did not response to all of topical steroid, non-steroidal anti-inϐlammatory drug (NSAID) and intravitreal anti-VEGF injection.