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KA Warren MD, ML Subramanian MD, CC Davis MD, JD Hunkeler MD; Cystoid Macular Edema After Clear Cornea Phacoemulsification . Invest. Ophthalmol. Vis. Sci. 2002;43(13):375.
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Purpose: To evaluate the incidence of cystoid macular edema (CME) after topical clear cornea phacoemulsification. Design: Prospective case study. Participants: Data on twenty-three (23) participants of two hundred (200) patients to be enrolled undergoing elective cataract surgery is presented. Method: Each patient must be at least 21 years of age and without evidence of preexisting CME. All patients underwent careful slit-lamp biomicroscopy to evaluate the macula for edema. Clear cornea cataract extraction with topical anesthesia by a single surgeon, and pre-operative, one-week(1), and six-week(6) fluorescein angiograms are performed in conjunction with clinical examination to assess the incidence of angiographic CME. Medical history of all patients including any present systemic disease, visual acuity, intraocular pressure, length of surgery and phacoemulsification time, any additional procedures or complications encountered during surgery, and incidence of post-operative clinical and angiographic CME was documented. Results: The average length of surgery was 9.4 minutes and the average phacoemulsification time was 56.6 seconds. At the one(1) and six(6) week follow-up, no eye revealed CME by slit-lamp biomicroscopy. Twenty-three(23) eyes at one-week and fifteen(15) eyes at six-weeks demonstrated no evidence of CME by fluorescein angiogram, and no patient reported symptoms that would suggest clinical CME at follow-up visits. Visual acuity improved for most patients (ave. 2.6 lines) and intraocular pressure was normal at each post-operative visit. Conclusion: Patients undergoing clear cornea cataract extraction with short surgery and phacoemulsification times and absence of intraoperative or post-operative complications have a very low incidence of Irvine-Gass syndrome. More patients and additional data including preexisting medical conditions, surgery and phacoemulsification times, and intraoperative complications is needed to accurately assess the incidence and predisposing factors of post-cataract extraction CME.
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