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H. Wafapoor, A. M. Eaton; Perioperative Characteristics of Eyes With Epiretinal Membrane Undergoing Uncomplicated Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6090.
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To determine whether the presence of epiretinal membrane would increase the development of macular edema in eyes undergoing uneventful cataract extraction.
A retrospective chart review of Thirty-seven consecutive eyes with epiretinal membrane, which underwent uncomplicated phacoemulsification with posterior chamber intraocular lens implantation from 6/2007 to 10/2008 was performed. The eyes were examined 1 month prior to surgery and 6 to 8 weeks after surgery. Complete eye exam including fluorescein angiography (FA) and optical coherence tomography (OCT) was performed.
Prior to surgery 7 eyes (19%) had leakage on FA, 17 eyes (46%) showed perifoveal capillary dragging, and central macular thickness (CMT) on OCT was 320 µ ± 84 (range:212 to 537 µ). Following uneventful cataract surgery 17 eyes (46%) had leakage on FA, CMT on OCT was 343 µ ± 90 (range 212 to 532 µ). Eighteen eyes (49%) required treatment, of which 10 eyes (56%) received eye drops, 5 eyes (28%) needed subtenon Triamcinolone injection, 2 eyes (11%) required vitrectomy, and 1 eye (6%) received intraocular steroid injection. Macular edema resolved in 7 eyes (39%). Seven eyes (39%) had no resolution of macular edema, however, the edema was deemed visually not significant, 2 eyes (11%) developed chronic macular edema ,and 2 eyes (11%) were lost to follow-up. FA leakage prior to cataract surgery was found to be a risk factor for developing macular edema. (p<0.005).
Cataract surgery in eyes with epiretinal membrane has a high rate of morbidity. About half of eyes develop macular edema detected on FA or OCT, requiring medical or surgical treatments. Leakage on FA prior to cataract surgery seems to be a risk factor for worsening edema. This study highlights the importance of screening patients with OCT for the detection of epiretinal membrane prior to cataract extraction.
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