Abstract
Purpose :
This retrospective study documents the prevalence of post-operative macular edema (pME) for patients with retinal vein occlusion (RVO) undergoing cataract surgery and investigates the correlation between pre-operative anti-VEGF injections (anti-VEGF) and the reduction of pME.
Methods :
We conducted a retrospective chart review of 81 eyes from 79 patients that shared ICD-10 codes for RVO and CPT codes for cataract surgery between 2013 and 2023. Exclusion criteria included history of DME, complex cataract surgery, prior ocular surgery, carbonic anhydrase inhibitor, steroid, and ketorolac use. Data collected and analyzed included preoperative and postoperative central subfield thickness (CST) and average cube thickness (ACT) on optical coherence tomography (OCT), past medical and ocular history, and timing of anti-VEGF treatment relative to cataract surgery. pME was defined as a greater than 30% increase in CST after cataract surgery. In total, 53 eyes from 51 patients were included. Statistical analysis was done in Python 3.12.0 using Student’s t-test.
Results :
The prevalence of pME in our population was 41.51%. For patients with a history of anti-VEGF, the prevalence of pME was 28.95% while patients who have never received anti-VEGF had a prevalence of 73.33%. In patients who were previously treated with anti-VEGF, there was a significant decrease in pME in patients who received their last treatment less than 35 days prior to CE (12.5%, n=24) when compared with those that received it greater than 35 days prior to CE (57.1%, n=14; p<0.05). No such difference was observed in ACT (p>0.05).
Conclusions :
This research identifies a high prevalence of pME for patients with RVO when compared to the documented rate of pME in the general population. This prevalence was high in patients regardless of treatment with anti-VEGF in the past. Previously treated patients have improved outcomes regarding pME if they receive an injection within 35 days before their cataract surgery. This study is the first to provide evidence and a suggested time course for delivery of anti-VEGF injections in this patient group prior to cataract surgery to prevent pME. Future studies are needed to prospectively characterize the benefit of pre-operative anti-VEGF injections for patients with RVO undergoing CE on pME.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.