June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Development of cystoid macular edema following rhegmatogenous retinal detachment surgery
Author Affiliations & Notes
  • Matthew Starr
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Louis Cai
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Michael Ammar
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Luv Patel
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Anthony Obeid
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Ed Ryan
    VitreoRetinal Surgery, PA, Minnesota, United States
  • Claire Ryan
    VitreoRetinal Surgery, PA, Minnesota, United States
  • Antonio Capone
    Beaumont Health, Royal Oak, Michigan, United States
  • Geoffrey Emerson
    The Retina Center, Minnesota, United States
  • Daniel Joseph
    Barnes Retina Institute, Saint Louis, Missouri, United States
  • Dean Eliott
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Omesh Gupta
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Carl Regillo
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Jason Hsu
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Yoshihiro Yonekawa
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Matthew Starr, None; Louis Cai, None; Michael Ammar, None; Luv Patel, None; Anthony Obeid, None; Ed Ryan, None; Claire Ryan, None; Antonio Capone, None; Geoffrey Emerson, None; Daniel Joseph, None; Dean Eliott, None; Omesh Gupta, None; Carl Regillo, None; Jason Hsu, None; Yoshihiro Yonekawa, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 3657. doi:
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      Matthew Starr, Louis Cai, Michael Ammar, Luv Patel, Anthony Obeid, Ed Ryan, Claire Ryan, Antonio Capone, Geoffrey Emerson, Daniel Joseph, Dean Eliott, Omesh Gupta, Carl Regillo, Jason Hsu, Yoshihiro Yonekawa; Development of cystoid macular edema following rhegmatogenous retinal detachment surgery. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3657.

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      © ARVO (1962-2015); The Authors (2016-present)

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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.

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