July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Preoperative topical prostaglandin use and the incidence of postoperative cystoid macular edema and persistent inflammation after cataract surgery
Author Affiliations & Notes
  • Alina Lou
    Vanderbilt Eye Institute, Nashville, Tennessee, United States
  • David Vollman
    Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States
    Department of Ophthalmology, St. Louis VA Healthcare System, St. Louis, Missouri, United States
  • Mary K Daly
    Department of Ophthalmology, VA Boston Healthcare System, Jamaica Plain, Massachusetts, United States
  • Qingxia Chen
    Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, United States
  • Amy Chomsky
    Department of Ophthalmology, VA Tennessee Valley Healthcare System, Nashville, Tennessee, United States
    Vanderbilt Eye Institute, Nashville, Tennessee, United States
  • Footnotes
    Commercial Relationships   Alina Lou, None; David Vollman, None; Mary Daly, None; Qingxia Chen, None; Amy Chomsky, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 480. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Alina Lou, David Vollman, Mary K Daly, Qingxia Chen, Amy Chomsky; Preoperative topical prostaglandin use and the incidence of postoperative cystoid macular edema and persistent inflammation after cataract surgery. Invest. Ophthalmol. Vis. Sci. 2019;60(9):480.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : There is currently no clear consensus on the discontinuation of topical prostaglandin analogs preoperatively to prevent pseudophakic cystoid macular edema (CME). This retrospective study was conducted to elucidate the association between preoperative topical prostaglandin use and (1) the incidence of clinical pseudophakic cystoid macular edema, and (2) persistent postoperative inflammation.

Methods : The Ophthalmic Outcomes Surgical Database of 4923 phacoemulsification cases performed at 5 United States Veterans Affairs (VA) hospitals between January 2001 and June 2006 was analyzed. Patients with a history of prior intraocular surgery, macular edema, intraoperative posterior capsule rupture or zonular dehiscence, and patients whose topical prostaglandins were stopped preoperatively were excluded. CME was diagnosed based on presence of macular thickening on exam. Adjusting for diabetes and uveitis, the association between preoperative topical prostaglandin use and (1) postoperative CME and (2) postoperative inflammation at 1 month were examined by logistic regression or penalized logistic regression when needed.

Results : A total of 3892 cases were included. Of these, 183 were on a topical prostaglandin analog; only 1 was diagnosed with CME. 13 cases of CME were diagnosed in patients who were not on topical prostaglandins. Adjusting for history of diabetes and uveitis, preoperative prostaglandin use was not associated with postoperative CME (p=0.710). Preoperative topical prostaglandin use was significantly associated with postoperative inflammation at 1 month (p=0.0077) and with decreased postoperative best corrected visual acuity (BCVA) (p=0.0001).

Conclusions : Our study shows that there is no association between preoperative topical prostaglandin use and clinical pseudophakic CME. There was a significant association between preoperative topical prostaglandin use and persistent postoperative inflammation at 1 month. Topical prostaglandins may not need to be discontinued prior to cataract surgery, especially if discontinuation could risk progression of glaucoma. However, it is important to acknowledge that these patients could have prolonged inflammation after surgery, requiring a longer course of topical corticosteroids. The significant decrease in postoperative BCVA will require further investigation.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×