Impact of prior pars plana vitrectomy on development of cystoid macular edema after uneventful cataract surgery

Abstract

Purpose: 

To investigate whether a 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, New York.

Design: 

Retrospective cohort study.

Methods: 

Records of 365 subjects who underwent PPV for RRD and subsequent cataract surgery between 2017 and 2020 were reviewed. Patients with a history of diabetic retinopathy, inflammatory retinal vascular disease, uveitis, advanced age-related macular degeneration, 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 postoperatively were obtained.

Results: 

54 eyes underwent uneventful cataract surgery by phacoemulsification and had a history of PPV with gas tamponade. 55 eyes underwent uneventful cataract surgery only. The average follow-up time after cataract surgery was 39.1 months. In eyes with a history of PPV, the incidence of OCT-detected CME was 27.8% (15/54) compared with 3.8% (2/55) in the control group (P < .001) and the incidence of clinically significant CME was 18.5% (10/54) compared with 1.8% (1/55) in the control group (P = .004). 80% (12/15) of CME cases were treated with topical therapy, and none required intravitreal injection.

Conclusions: 

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.

In Brief

History of rhegmatogenous retinal detachment repaired by pars plana vitrectomy with gas tamponade was associated with an increased incidence of pseudophakic after uneventful cataract surgery.