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Rachel Healy, Charlotte Buscombe, Colin J Chu, Quresh Mohamed, Ahmed A I Sallam, Robert Johnston; The incidence of cystoid macular edema after cataract surgery and the effect of posterior capsule rupture. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):670.
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© ARVO (1962-2015); The Authors (2016-present)
To quantify the incidence of clinically significant cystoid macular edema (CME) following cataract surgery and assess the relative risk from intraoperative complications.
<br /> <br /> The UK Royal College of Ophthalmologists Diabetic Eye Disease and Cataract National Datasets were collected prospectively within an electronic medical record system (Medisoft Ophthalmology) from a single UK centre. Data collection included compulsory reporting of operative and post-operative complications. All patients were prescribed four weeks of reducingtopical steroid and had at least a single follow-up appointment an average of five weeks after surgery. A new diagnosis of CME on the electronic medical record system within 90 days of surgery was the primary outcome. Patients with diabetes and the documentedabsence of diabetic retinopathy and maculopathy were included. Patients with pre-existing CME, uveitis, vein occlusion, epiretinal membrane, previous use of intravitreal steroid/anti-VEGF agents or receiving perioperative NSAIDs were excluded.
9,776 consecutive phacoemulsification operations performed by 54 different surgeons between August 2010 and August 2014 fulfilled the selection criteria.59.6% of eyes were from females and 5.84% from patients with diabetes. The mean age for the cohort was 76 years at the time of surgery. An incidence of CME of1.44% was determined for patients with no operative complications. The relative risk (RR) following posterior capsule rupture was statistically significantly at 5.05 (95% CI, 2.63-9.68*). The RR from iris trauma was 1.39 (95% CI, 0.20-9.76) and a documented small pupil gave a RR of 1.19 (95% CI, 0.44-3.19) however neither factor was statistically significant.
This is the largest retrospective study to report the incidence of CME after cataract extraction and the effect of surgical complications. It provides a benchmark incidence for patients and provides supportfor the need to consider additional prophylactic treatment.
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