Incidence and remission of post-surgical cystoid macular edema following cataract surgery in eyes with intraocular inflammation

Sapna Gangaputra, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: sapna.gangaputra@vumc.org.
Craig Newcomb, Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Gui-Shuang Ying, Department of Ophthalmology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Sylvia Groth, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Tonetta D. Fitzgerald, Department of Ophthalmology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Pichaporn Artornsombudh, Department of Ophthalmology, Somdech Phra Pinkloa Hospital, Royal Thai Navy, Bangkok, Thailand.; Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand.
Srishti Kothari, Department of Ophthalmology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.
Siddharth S. Pujari, Siddharth Netralaya Superspecialty Eye Hospital, Belgaum, Karnataka, India.
Douglas A. Jabs, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Grace A. Levy-Clarke, Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, USA.
Robert B. Nussenblatt, Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
James T. Rosenbaum, Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA.; Department of Medicine, Oregon Health and Science University, Portland, Oregon, USA.; Legacy Devers Eye Institute, Portland, Oregon, USA.
H Nida Sen, Department of Ophthalmology, George Washington University, Washington, District of Columbia, USA.; Janssen Retina Global Clinical Development, Princeton, New Jersey, USA.
Eric B. Suhler, Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA.; Portland Veteran's Affairs Medical Center, Portland, Oregon, USA.
Jennifer E. Thorne, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Nirali P. Bhatt, Department of Ophthalmology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
C Stephen Foster, Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA; Department of Ophthalmology and Schepens Eye Research Institute, Massachusetts; Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
Kurt A. Dreger, Department of Ophthalmology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Jeanine M. Buchanich, Center for Occupational Biostatistics and Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.
John H. Kempen, Department of Ophthalmology and Schepens Eye Research Institute, Massachusetts; Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.; Sight for Souls, Bellevue, Washington, USA.; MCM Eye Unit; MyungSung Christian Medical Center (MCM) General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia.; Department of Ophthalmology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia. Electronic address: John_kempen@meei.harvard.edu.

Document Type

Journal Article

Publication Date

6-14-2024

Journal

American journal of ophthalmology

DOI

10.1016/j.ajo.2024.06.006

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 18-44 and aOR 1.93 for ages 45-64, overall p = 0.02); concurrent use of systemic immunosuppression (conventional aOR 1.53 and biologics aOR 2.68, overall p =0.0095); pre-operative VA 20/50 or worse (overall p <0.0001); cataract surgery performed before 2000 (overall p=0.03) and PMCE in fellow eye (aOR 3.04, p=0.0004) 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.

Department

Ophthalmology

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