Abstract
Purpose :
Pseudophakic cystoid macular edema is the most common complication of cataract surgery.Multiple risk factors and surgical complications have been associated with this entity.Whether Posterior Chamber Intraocular lens or Transconjunctival Scleral Fixated intraocular lens carry a different risk of PCME has not been studied.
Methods :
Retrospective chart review of 30 patients undergoing Cataract Extraction with Phacoemulsification/IOL by different techniques between January 2018 and January 2019 to identify which IOL placement technique is associated with the least risk of PCME.Records were reviewed for age,history,gender,ethnicity,IOL placement technique, preoperative/postoperative BCVA,and macula OCT.The inclusion criteria were cataract extraction from 1/18 to 1/19, preoperative/postoperative BCVA, and OCT.The exclusion criteria were topical PGA, DME, CME, macular atrophy, ERM,Uveitis,RVO,or retained lens fragments.
Results :
From January 2018 to January 2019, 15 patients underwent TCSFIOL and 15 PCIOL.Groups were compared for Age, Sex, Race, Mean Preoperative BCVA, Mean Postoperative BCVA, and average Foveal thickness by macula OCT.The mean age of the TCSFIOL was 71.2 +/- 10 and 70.8 +/- 9 for the PCIOL group.All patients were of Hispanic descent. The TCSFIOL group had 60% male/40% female and the PCIOL group had 80% female/20% male.The Mean Preoperative BCVA was 20/400 in the TCSFIOL group and 20/80 in the PCIOL with a P value of 0.0539.The Mean Postoperative BCVA was 20/60 ->TCSFIOL group and 20/25 -> PCIOL with a P value of 0.8.The average foveal thickness was 280.8 mm for the TCSFIOL and 269.6 mm for the PCIOL group with a Pvalue of 0.2.
Conclusions :
Although one patient in each group had central foveal thickness slightly >300 μm, retinal thickness is not sufficiently accurate to diagnose PCME. In our study groups no patients developed PCME diagnosed by OCT. Unclear if angiographic PCME was present as most patients did not obtain Fluorescein Angiography. At this moment there is insufficient evidence to choose one IOL placement technique over the other based on this data. Limitations include number of patients that have undergone TCSFIOL, absence of Fluorescein Angiography, lost to follow-up, prior macular pathology, and multiple ocular comorbidities/surgeries. Would expand to lens positioning/tilt and assess if correlation with PCME diagnosed by OCT and Fluorescein Angiography.
This is a 2020 ARVO Annual Meeting abstract.