Incidence and Remission of Post-Surgical Cystoid Macular Edema Following Cataract Surgery in Eyes With Intraocular Inflammation

Am J Ophthalmol. 2024 Nov:267:182-191. doi: 10.1016/j.ajo.2024.06.006. Epub 2024 Jun 15.

Abstract

Purpose: To evaluate the incidence, remission, and relapse of post-surgical cystoid macular edema (PCME) following cataract surgery in inflammatory eye disease.

Methods: A total of 1859 eyes that had no visually significant macular edema prior to cataract surgery while under tertiary uveitis management were included. Standardized retrospective chart review was used to gather clinical data. Univariable and multivariable logistic regression models with adjustment for inter-eye correlations were performed.

Results: PCME causing VA 20/50 or worse was reported in 286 eyes (15%) within 6 months of surgery. Adults age 18-64 years as compared to children (adjusted odds ratio [aOR] = 2.42, for ages 18 to 44 years and aOR = 1.93 for ages 45 to 64 years, overall P = .02); concurrent use of systemic immunosuppression (conventional aOR 1.53 and biologics aOR = 2.68, overall P = .0095); preoperative VA 20/50 or worse (overall P < .0001); cataract surgery performed before 2000 (overall P = .03) and PMCE in fellow eye (aOR = 3.04, P = .0004) were associated with development of PCME within 6 months of cataract surgery. PCME resolution was seen in 81% of eyes at 12 months and 91% of eyes at 24 months. CME relapse was seen in 12% eyes at 12 months and 19% eyes at 24 months.

Conclusions: PCME occurs frequently in uveitic eyes undergoing cataract surgery; however, most resolve within a year. CME recurrences likely are due to the underlying disease process and not relapses of PCME.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cataract Extraction / adverse effects
  • Child
  • Female
  • Humans
  • Incidence
  • Lens Implantation, Intraocular
  • Macular Edema* / diagnosis
  • Macular Edema* / etiology
  • Male
  • Middle Aged
  • Phacoemulsification / adverse effects
  • Postoperative Complications* / epidemiology
  • Recurrence
  • Retrospective Studies
  • Uveitis / complications
  • Uveitis / diagnosis
  • Visual Acuity* / physiology
  • Young Adult