Abstract
Purpose::
The objective of this study is to assess the frequency, associated factors, and surgical outcomes of clinical and subclinical cystoid macular edema (CME) in post-surgical patients using optical coherence tomography (OCT).
Methods::
This is a prospective, observational study, performed at one clinical center, New England Eye Center (NEEC). Males and females, aged 18 years and above, who have undergone cataract extraction, Nd:YAG capsulotomy, LASIK, PRK, IOL exchange, PKP, triple procedure (phacoemulsification, IOL transplant, and PKP), LPI, ALT and SLT, trabeculectomy, glaucoma valve implant, retinal detachment repair, macular hole repair, and pterygium excisionwere enrolled. Visual acuity measurement, clinical examination, fundus photography, and imaging with OCT were performed at baseline and postoperatively on Day One (except patients undergoing glaucoma laser procedures and Nd:YAG capsulotomy), Week One, Month One, Month Six, and Year One. When CME was present, more frequent evaluations were performed.
Results::
The 3-4% reported incidence of CME for phacoemulsification extracapsular cataract surgery was verified. Literature reports 0-4% and 20-50% incidence of CME following Nd:Yag capsulotomy and aphakic and pseudophakic PK respectively, depending on the researchers’ study design and whether CME was identified via biomicroscopic examination or use of fluorescein angiography. This study defines the incidences of CME for these surgical procedures using OCT imaging. There are currently no reports in the literature of CME following LASIK, PRK, IOL exchange, phakic PKP, triple procedure (phacoemulsification, IOL transplant, and PKP), LPI, ALT and SLT, trabeculectomy, glaucoma valve implant, phakic retinal detachment repair, and pterygium excision. We report the incidences of CME for these surgical procedures for the first time.
Conclusions::
The incidences, associated factors, and surgical outcomes of clinical and subclinical CME following various surgical procedures are established using OCT. This imaging modality enables noninvasion evaluation and monitoring of postsurgical CME and subsequent improved patient management.