Development of cystoid macular edema following rhegmatogenous retinal detachment surgery

Abstract

Purpose : Cystoid macular edema (CME) following cataract surgery is a well-known phenomenon. Less is known regarding the risk factors, though, of developing CME following repair of rhegmatogenous retinal detachments (RRD).

Methods : This is a subgroup analysis of the Primary Retinal Detachment Outcomes (PRO) study, a multi-institutional study of consecutive primary RRD surgeries from 1/1/2015 through 12/31/2015. The primary outcome was development of post-operative CME following RRD surgery. The analysis was limited with those with post-operative optical coherence tomography imaging and at least 3 months of follow up following RRD repair.

Results : There were 1,466 eyes that met the inclusion criteria, and 140 (9.6%) developed post-operative CME following primary RRD repair. Multivariate analyses with statistically significant associationswere older patient age (OR 1.03 per year, 95% CI 1.01 to 1.05), pre-operative proliferative vitreoretinopathy (PVR, OR 1.74, 95% 1.03 to 2.95), and cataract surgery following RRD repair (OR 2.18, 95% CI 1.47 to 3.25). Of the 843 (57.7%) phakic eyes, 76 (9.0%) developed post-operative CME. Multivariate analysis showed that cataract surgery following RRD repair was an independent risk factor (p < 0.0001) in this subset. Of the 623 (42.3%) pseudophakic eyes, 60 (9.9%) developed post-operative CME. Older age was an independent risk factor (p = 0.0075). When examining only eyes that underwent successful retinal re-attachment with a single surgery, 77 of 1211 (6.4%) eyes developed CME. Post-operative cataract surgery (p = 0.0005) and pre-operative PVR (p = 0.0011) were the independent risk factors for CME based on multivariate analyses in this subgroup. Of note, vitrectomy and vitrectomy with scleral buckle resulted in higher rates of CME compared to scleral buckle alone on univariate analyses, but did not remain statistically significant on multivariate regression analysis.

Conclusions : CME occurred in nearly 10% of eyes following RRD repair. The biggest risk factors were recurrent retinal detachment, preexisting PVR, older age, and cataract surgery following RRD repair.

This is a 2021 ARVO Annual Meeting abstract.