Abstract
Purpose :
The suturing of posterior chamber intraocular lenses in complex cases may result in a high incidence of post-operative macular edema. The ability to better predict which eyes are at most risk could potentially lead to strategies to mitigate this sight-threatening complication.
Methods :
A retrospective chart review was performed of all consecutive sutured intraocular lenses done by one surgeon at one center between June 1, 2016 and June 1, 2018. Forty-six records were identified of patients that underwent this procedure with at least 3 months of post-operative follow-up. The age, diabetic status, pre-operative vision and pre-operative macular status (presence or absence of cystoid macular edema, diabetic macular edema, epiretinal membrane) were noted. The vision and presence or absence of macular edema 3 months after surgery were collected, as were those at month 6, if available. Whether or not the post-operative steroid drop regimen was tapered before post-operative week 2 was also noted.
Results :
Of the 46 eyes, 14 (30%) had some amount of macular edema, either on examination or imaging, at 3 months after surgery.
In eyes where steroid drops were tapered early, the rate was 40%, compared to 19%. Both the longer use of steroid drops and the absence of prior macular pathology were found to be contributors to the rate of macular edema at 3m (2-way ANOVA, p = 0.05 & 0.02). When looking at 6 month data however, 6/16 (38%) eyes in the early drop taper group and 5/13 (38%) in the late taper group had macular edema. Analysis of variance at the 6 month mark showed significance for pre-operative macular pathology (p = 0.05), but not drop regimen (p = 0.8).
Conclusions :
There is a high rate of cystoid macular edema following sutured lens implantation. There is a temporary benefit to a longer post-operatie steroid drop regimen, however not in the longer term. A pre-operative history of macular pathology is a high risk factor for post-operative edema.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.