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S. J. Kim, K. Jiramongkolchai, M. Lalezary; Influence of Previous Vitrectomy on Incidence of Macular Edema After Cataract Surgery in Diabetic Eyes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5072.
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To evaluate the effect of previous vitrectomy on the incidence of macular edema (ME) after cataract surgery in diabetic eyes.
Ninety phakic eyes of 70 diabetic patients undergoing non-emergent vitrectomy surgery were reviewed for rates of post-vitrectomy ME, cataract formation, and post-cataract surgery (post-cataract) ME. Preoperative and final best-corrected visual acuity were recorded. Baseline risk characteristics were analyzed.
Post-vitrectomy ME increases initially but then levels off at 28% by 4 years. Cumulative proportion of eyes requiring cataract surgery after vitrectomy climbs steadily reaching 40% at 4 years and 60% at 8 years. Of those eyes which underwent vitrectomy and then subsequent cataract surgery, incidence of post-vitrectomy ME was 6% at 6 months and post-cataract ME was 30% at 6 months (P < 0.02). Previous clinically significant macular edema (CSME) predicted development of post-cataract ME (P < 0.04).
Previous vitrectomy does not appear to lesson rates of post-cataract ME. Cataract formation is common after vitrectomy in diabetic eyes and risk of post-cataract ME is substantial and more likely in eyes with prior CSME. Cataract formation and risk of post-cataract ME should be considered when assessing the long-term benefits of vitrectomy surgery in diabetic patients.
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