Faricimab in the Management of Pseudophakic Cystoid Macular Edema (Irvine-Gass Syndrome): A Case Report

Background: Pseudophakic cystoid macular edema (CME), or Irvine-Gass syndrome, is a recognized complication of cataract surgery. While most cases respond to topical anti-inflammatory therapy, a subset develops persistent or late-onset edema requiring intravitreal intervention. Case Presentation: We report a 74-year-old female who developed CME in the left eye following phacoemulsification, with a postoperative course complicated by retained cataract fragments requiring surgical removal. Following an inadequate response to topical bromfenac sodium therapy, OCT confirmed clinically significant macular edema with a central macular thickness (CMT) of 620 μm and best-corrected visual acuity (BCVA) of 20/60, consistent with Irvine-Gass syndrome. The patient received a single intravitreal injection of faricimab (6.0 mg/0.05 mL). Intervention and Outcome: At six-week follow-up, CMT decreased to 249 μm (≈60% reduction) and BCVA improved to 20/30, with marked reduction in intraretinal and subretinal fluid and no treatment-related adverse events. Observation was maintained given the favorable anatomical response. Conclusion: This case suggests that faricimab, through its dual inhibition of VEGF-A and angiopoietin-2, may represent a potential therapeutic option in selected cases of late-onset or persistent pseudophakic CME, particularly where conventional topical anti-inflammatory therapy has proven insufficient.