June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Prognostic determinants of postoperative pseudophakic macular oedema in a tertiary hospital setting
Author Affiliations & Notes
  • Charles Hennings
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Komeil Alattar
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Mariana Batista Goncalves
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Siegfried Wagner
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Pearse Keane
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
    Biomedical Center, Moorfields Eye Hospital, National Institute for Health Research, London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Charles Hennings, None; Komeil Alattar, None; Mariana Goncalves, None; Siegfried Wagner, None; Pearse Keane, Allergan (R), Bayer (R), Bayer (S), Carl Zeiss Meditec (R), Deepmind (C), Haag-Streit (R), Heidelberg Engineering (R), Novartis (R), Novartis (S), Optos (C), Topcon (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2191. doi:
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      Charles Hennings, Komeil Alattar, Mariana Batista Goncalves, Siegfried Wagner, Pearse Keane; Prognostic determinants of postoperative pseudophakic macular oedema in a tertiary hospital setting. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2191.

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Abstract

Purpose : Post-operative pseudophakic cystoid macular oedema (PCMO) is a cause of impaired postoperative vision in modern cataract surgery. Known risk factors include intraoperative complications such as posterior capsule rupture and preoperative factors including diabetes mellitus, uveitis, vein occlusions and epiretinal membrane. A paucity in consistency of definition both clinically and with OCT imaging has led to a wide range of conclusions. Our aim is to report statistical baseline demographic and OCT characteristics in a patient cohort from a tertiary eye hospital setting

Methods : A data-warehouse query for all eyes receiving cataract surgery between January 2012 and December 2019 was performed. Inclusion criteria were age above 16, the presence of OCT imaging pre and postoperatively and at least 1 post-operative clinic letter. First and second eyes of patients were included but re-operations on the same eye were excluded. Datatables were merged and a Structured Query Language (SQL) fuzzy logic word search was performed on all electronic letters. Variations on PCMO nomenclature within these letters including, irvine-gass syndrome in both american and english spelling were identified. Sociodemographic (age, sex, ethnicity, socioeceonomic deprivation idnex), presence of diabetes mellitus and OCT longitudinal data were auto extracted and analysed. For validation purposes a subanalysis of random generated patient numbers was performed by hand for comparison on 15% of the entire cohort.

Results : 6287 patients were identified with operations performed on 9126 eyes. 53% were female, 2033 of British descent, 3647 of ethinic background the rest not being stated on the records. The average age at the time of surgery was 68.0 (SD 13.0) and 1804 patients were diabetic. The rate of all complications in this select cohort was 6.5% with a posterior capsular rupture rate of 1.1%. 56.0% of eyes were found to have PCMO. There was no statistical difference in the mean index of multiple deprivation score between those that developed PCMO (mean 5.2, SD 2.5) and those that did not (mean 4.9, SD 2.4, p = 0.16).

Conclusions : PCMO remains a risk in modern day cataract surgery regardless of intraoperative complications. OCT post-operatively is useful in its diagnosis and it can manifest sub-clinically. The use of postoperative NSAIDs in those known or at risk of PCMO can reduce its occurrence.

This is a 2021 ARVO Annual Meeting abstract.

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