Clinical cystoid macular edema after cataract surgery in glaucoma patients

Abstract

Purpose: To determine the prevalence of and risk factors for developing clinical cystoid macular edema (CME) after cataract surgery in patients with glaucoma.

Patients and methods: Medical records of patients who had cataract surgery between April 1998 and July 2006 without prior history of CME, a known risk factor to develop CME, or previous nonglaucoma ocular laser procedures or intraocular surgeries were reviewed. Clinical CME was diagnosed by fundus examination within 3 months postoperatively and confirmed with fluorescein angiography or optical coherence tomography. Outcome measures included prevalence of clinical CME by comparing patients with and without glaucoma; and risk factor analysis for clinical CME by comparing patients who did and did not develop CME after cataract surgery.

Results: Seven hundred patients (eyes) with glaucoma and 553 patients (eyes) without glaucoma were included. The prevalences of clinical CME in glaucoma and nonglaucoma patients were 5.14% and 5.79%, respectively (P=0.618). Patients who developed clinical CME (68 patients) had statistically higher rates of posterior capsule rupture or required anterior vitrectomy during surgery (P=0.010, odds ratio=3.35, 95% CI 1.33-8.45) compared with patients who did not develop clinical CME (1185 patients). No glaucoma medications used either preoperatively or postoperatively were associated with clinical CME (P>0.05).

Conclusions: Rupture of posterior capsule and anterior vitrectomy during cataract surgery is a potential risk factor for developing clinical CME after cataract surgery. There is no statistically significant difference in the prevalence of clinical CME after small corneal incision phacoemulsification cataract surgery between glaucoma and nonglaucoma patients.