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J. Kim, C. Ament, Z. Ferrufino-Ponce, A. Grabowska, S. L. Cremers, B. A. Henderson; Risk Factors for Clinical Pseudophakic Cystoid Macular Edema in Non-Diabetic Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5463.
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To characterize incidence, duration, risk factors for and outcome of post-cataract cystoid macular edema (CME) in non-diabetic patients.
1659 consecutive cataract surgeries performed between July 2001 and April 2006 were included. Cases were classified into two groups according to presence of CME. The diagnosis of CME required both worsening of vision and fundoscopic, fluorescein angiographic or optical coherence tomographic evidence of CME. Diabetics were excluded due to the potential difficulty of differentiating CME from clinically significant macular edema (CSME). Multivariate logistic regression analysis assessed predictive factors for postoperative CME.
The overall incidence of postoperative CME was 2.4% (39/1659) and 2.1% (29/1357) when diabetic patients were excluded. History of RVO (OR 31.75, P < .001), epiretinal membrane (ERM) (OR 4.93, P< .03) and pre-operative prostaglandin use (OR 12.45, P <.04) were predictive of postoperative CME. Patients who have known increased risk factors for CME (Diabetes and intraoperative complications) did not have an increased risk when treated with prophylactic postoperative NSAIDs for at least 1 to 3 months.
Non-diabetic patients with a history of RVO, ERM, and preoperative prostaglandin use have an increased risk of postoperative CME. Treating patients with a higher risk of developing CME with topical NSAIDs after cataract surgery appears to decrease risk of postoperative CME.
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