Purchase this article with an account.
Arthi Venkat, Megan Rudolph, Veena Raiji, Jeevan R Mathura, Lindsay Smithen, Sankaranarayana Mahesh; Evaluation of treatment outcomes for Cystoid Macular Edema following Cataract Surgery.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):187.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate treatment outcomes and identify potential risk for persistent cystoid macular edema following cataract surgery.
We performed a retrospective chart review of 25 patients who developed cystoid macular edema after cataract surgery with a minimum follow up of 180 days. Patients were classified as I) topical therapy alone, II) topical+ intravitreal/periocular pharmacological therapy, III) topical and laser therapy, and IV) topical and injected pharmacological therapy and focal laser. Retinal thickness before and after treatment was analyzed by optical coherence tomography (OCT).
The mean age was 72.7+/-10.1 years (range 40-90 yrs). 11 patients (44%) had diabetes, of which 8 (32%) had retinopathy at the time of cataract surgery. Baseline and final logmar VA were 0.54 and 0.40 respectively with mean follow-up time of 744.4 +/- 632 days. 48% received topical treatment (NSAIDs and/or steroids), 24% received topical therapy and intravitreal or periocular injection, 20% received topical therapy, injection and laser, and 8% received topical and laser therapy. Mean initial and final OCT subfoveal thickness were 430.5 +/- 117.0 and 325.12 +/- 170.4 respectively, demonstrating a statistically significant decrease (P=0.0009).<br /> <br /> 19 eyes (76%) experienced resolution of edema, with mean resolution time of 260 +/- 317 days and mean follow-up time of 749 +/- 656 days. Within this group, 26% were diabetic and 21% had retinopathy. Mean initial and final subfoveal thickness were 397.9 +/- 107.9 and 267.1 +/- 117.0 respectively. The majority of this group (63.2%) received topical treatment alone, while 21% required additional injection and 15.5% required laser therapy. Of the 6 (24%) patients with persistent edema, all were diabetic and were likely to have higher baseline subfoveal thickness (533.7+/- 83.7) compared to patients with resolved macular edema (397.8+/-107.9) suggestive of more aggressive disease (P=0.01). Patients with persistent edema were more likely to require combination therapy (33% group III, 67% group IV). Cystic edema was the most common morphologic finding on OCT (56%).
Patients who have diabetes are more likely to have persistent macular edema following cataract surgery and might benefit from more aggressive and combination therapy.
This PDF is available to Subscribers Only