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PREOPERATIVE VITREORETINAL INTERFACE ABNORMALITIES ON SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY AS RISK FACTOR FOR PSEUDOPHAKIC CYSTOID MACULAR EDEMA AFTER PHACOEMULSIFICATION

Copete, Sergio, MD, PhD*; Martí-Rodrigo, Pablo, MD*; Muñiz-Vidal, Romina, MD, PhD*; Pastor-Idoate, Salvador, MD, PhD*; Rigo, Jaume, MD; Figueroa, Marta S., MD, PhD‡,§; García-Arumí, JOSÉ, MD, PhD*; Zapata, Miguel A., MD, PhD*,¶

doi: 10.1097/IAE.0000000000002298
Original Study: PDF Only

Purpose: We assessed the role of vitreoretinal interface status in the development of pseudophakic cystoid macular edema (PCME) after cataract surgery.

Methods: Prospective cohort study in which 112 patients (112 eyes) scheduled for cataract surgery were selected at random to undergo spectral domain optical coherence tomography (OCT) within 1 week preoperatively and at 1 and 3 months postoperatively. Spectral domain OCT macular images included no vitreoretinal contact, focal and diffuse vitreomacular adhesion, focal and diffuse vitreomacular traction, epiretinal membrane, macular hole, and macular edema.

Results: The incidence of PCME was 11.6% (13 eyes), all of them being diagnosed at 1 month, and 7 eyes resolved at 3 months. The only risk factor for PCME was detection of nonsurgical epiretinal membrane by spectral domain OCT before phacoemulsification, being developed in 5 of 16 eyes (χ2 = 0.08, odds ratio 4.53, 95% confidence interval 1.28–16.13). Other variables such as posterior vitreous detachment, subfoveal choroidal thickness, diabetes, or hypertension were not significantly associated with PCME.

Conclusion: In this cohort, preoperative detection of epiretinal membrane by spectral domain OCT was a risk factor for PCME after cataract extraction. It is recommended to perform a spectral domain OCT before cataract surgery because the presence of an epiretinal membrane may be passed unnoticed by fundus examination.

Preoperative detection of epiretinal membrane by spectral domain optical coherence tomography is a risk factor for pseudophakic cystoid macular edema after phacoemulsification. The presence of an epiretinal membrane may be passed unnoticed by fundus examination, so that performing spectral domain optical coherence tomography in the workup studies before cataract surgery should be recommended.

*Retina Department, Service of Ophthalmology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. Dr. Copete is now with the Department of Ophthalmology, Castilla-La Mancha University, Albacete, Spain;

Glaucoma Department, Service of Ophthalmology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain;

Retina Division, Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Madrid, Spain;

§Vissum Madrid, Madrid, Spain; and

Oftalis, Institut d'Oftalmologia, Clinica Girona, Girona, Spain.

Reprint requests: Sergio Copete, MD, PhD, Department of Ophthalmology, Facultad de Medicina de Albacete, Castilla-La Mancha University, C/Almansa 14, E-02006 Albacete, Spain; e-mail: sergiocp.ab@gmail.com

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.