The incidence of cystoid macular edema following uncomplicated phaco-emulsification cataract surgery in patients with and without epiretinal membrane

Abstract

Purpose : Retrospective studies have implicated epiretinal membrane (ERM) as a risk factor for cystoid macular edema (CME) following uncomplicated phaco-emulsification cataract surgery, but our review of the literature revealed no prospective studies. This prospective, comparative, cohort study was undertaken to determine if the incidence of postoperative CME is increased in patients with ERM and no other risk factors.

Methods : Eighty-four patients with ERM and 645 patients without ERM who met the inclusion criteria and underwent uncomplicated cataract surgery in a private group practice were evaluated preoperatively and approximately one month postoperatively with spectral domain-optical coherence tomography (SD-OCT). All patients were treated postoperatively with the same 4-week regimen of topical steroid and nonsteroidal eye drops. The incidence of CME and average increase in OCT central subfield thickness (CST) between the two groups were analyzed using a two-sample independent t-test. Multiple regression analyses were performed to assess the predictive factors for change in CST and rate of postoperative CME.

Results : Patients with ERM had a mean preoperative CST of 350.70 ± 76.37mm vs. 261.72 ± 22.69mm in the control group. The ERM group had a statistically significant increase in CST following surgery (16.95mm vs. 7.64mm; p≤ 0.001), however, this change in CST was not large enough to result in vision loss or CME. There was no statistically significant difference in the incidence of CME in the ERM group vs. the control group (2.38% vs. 1.86%; p=0.74). The change in CST and the likelihood of a patient developing CME were unrelated to the patient’s gender, age, eye, pre-operative OCT thickness, pre-operative visual acuity, surgical time, or surgeon.

Conclusions : In this prospective study, there was no significant difference in the incidence of CME following uncomplicated phaco-emulsification cataract surgery in patients with and without preexisting ERM in the absence of other risk factors when treated postoperatively with the combination of topical steroidal and nonsteroidal eye drops.

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