Incidence of Cystoid Macular Edema after Cataract Surgery in Patients with and without Uveitis Using Optical Coherence Tomography

• Published in: American journal of ophthalmology 2009-07, Vol.148 (1), p.128-135.e2
• Main Authors: Bélair, Marie-Lyne, Kim, Stephen J, Thorne, Jennifer E, Dunn, James P, Kedhar, Sanjay R, Brown, Diane M, Jabs, Douglas A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cataracts; Confidence intervals; Diabetes; Diabetic retinopathy; Eye surgery; Female; Follow-Up Studies; Humans; Immunology; Incidence; Lens diseases; Lens Implantation, Intraocular; Macular Edema - diagnosis; Macular Edema - epidemiology; Male; Medical sciences; Middle Aged; Miscellaneous; Older people; Ophthalmology; Patients; Phacoemulsification; Postoperative Complications; Prospective Studies; Retinopathies; Risk Factors; Surgery; Surgical outcomes; Tomography, Optical Coherence; Uveitis - complications; Visual Acuity - physiology; Young Adult
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2009.02.029

Purpose To determine the incidence of cystoid macular edema (CME) after cataract surgery among eyes with and without uveitis using optical coherence tomography (OCT) and to determine risk factors for postoperative CME among eyes with uveitis. Design Prospective, comparative cohort study. Methods Single-center, academic practice. Forty-one eyes with uveitis and 52 eyes without uveitis underwent clinical examination and OCT testing within 4 weeks before cataract surgery and at 1-month and 3-month postoperative visits. The main outcome measure was incidence of CME at 1 and 3 months after surgery. Results Both uveitic and control eyes gained approximately 3 lines of vision ( P = .6). Incidence of CME at 1 month was 12% (5 eyes) for uveitis and 4% (2 eyes) for controls ( P = .2). Incidence of CME at 3 months was 8% (3 eyes) for uveitis and 0% for eyes without uveitis ( P = .08). Eyes with uveitis treated with perioperative oral corticosteroids had a 7-fold reduction in postoperative CME (relative risk [RR], 0.14; P = .05). In uveitic eyes, active inflammation within 3 months before surgery increased the risk of CME when compared with eyes without inflammation (RR, 6.19; P = .04). CME was significantly associated with poorer vision ( P = .01). Conclusions Eyes with well-controlled uveitis may obtain similar outcomes to control eyes after cataract surgery (up to 3 months). Use of perioperative oral corticosteroids and control of uveitis for more than 3 months before surgery seemed to decrease the risk of postoperative CME among uveitic eyes in this study.