Cystoid Macular Edema in Eyes Undergoing Pars Plana Vitrectomy for Retained Lens Fragments

Abstract

Abstract: : Purpose: To investigate the incidence of visually significant cystoid macular edema (CME) associated with retained lens fragments managed by pars plana vitrectomy (PPV), and clinical features predictive of visual acuity outcomes. Methods: Retrospective, noncomparative, consecutive case series including all patients who underwent removal of retained lens fragments after cataract surgery by PPV at a single institution between January 1,1990, and December 31, 2000. Demographic and clinical data were extracted from patients' medical records. Results: The study included 303 patients with a mean age of 76 years and a median follow-up period of 8 months. Clinically significant CME occurred at some point during their clinical course in 81/303 (26.7%)eyes. Presenting intraocular pressure >35mmHg was significantly associated with a lower rate of CME compared to eyes with IOP <35 mmHg (p=0.009). Patient age, type of intraocular lens, degree of inflammation and presenting visual acuity were not significant predictors for the development of CME. Visual acuity at final follow-up was >20/40 in 20/71(28.2%), 20/50- 20/100 in 28/71(39.4%), 20/200- 5/200 in 19/17(26.8%), and less than 5/200 in 4/71 (5.6%). CME was the most common primary cause of final visual acuity less than 20/40, occurring in 45/167(26.9%) eyes. Conclusions: In the current series, clinically significant CME was a frequent complication in eyes undergoing PPV for removal of retained lens fragments after cataract surgery and was the most common cause of final vision less than 20/40.

Keywords: retina • cataract • macula/fovea