Purpose:
To investigate whether history of prior pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) predisposes to the development of pseudophakic cystoid macular edema (CME).
Setting:
New York Eye and Ear Infirmary of Mount Sinai, New York, USA
Design:
Retrospective cohort study
Methods:
Records of 365 subjects who underwent PPV for RRD and subsequent cataract surgery between 2017-2020 were reviewed. Patients with a history of diabetic retinopathy, inflammatory retinal vascular disease, uveitis, advanced age-related macular degeneration (AMD), intraocular infection, myopic maculopathy, or significant intraoperative complications precluding posterior chamber intraocular lens placement were excluded. Age-matched subjects who underwent routine cataract surgery served as controls. Clinical data and macular optical coherence tomography (OCT) findings up to 4 years after surgery were obtained.
Results:
Fifty-four eyes underwent uneventful cataract surgery by phacoemulsification and had a history of PPV with gas tamponade. Fifty-five eyes underwent uneventful cataract surgery only. Average follow up time after cataract surgery was 39.1 months. In eyes with history of PPV, the incidence of OCT-detected CME was 27.8% (15/54) compared to 3.8% (2/55) in the control group (p<0.001), and the incidence of clinically significant CME was 18.5% (10/54) compared to 1.8% (1/55) in the control group (p=0.004). 80% (12/15) of CME cases were treated with topical therapy and none required intravitreal injection.
Conclusion:
Prior PPV for RRD is associated with an increased incidence of pseudophakic CME after uneventful cataract surgery. Prophylactic or prolonged postoperative anti-inflammatory topical therapy may be prudent to consider in these patients.
