Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov:267:182-191.
doi: 10.1016/j.ajo.2024.06.006. Epub 2024 Jun 15.

Incidence and Remission of Post-Surgical Cystoid Macular Edema Following Cataract Surgery in Eyes With Intraocular Inflammation

Sapna Gangaputra  1 , Craig Newcomb  2 , Gui-Shuang Ying  3 , Sylvia Groth  4 , Tonetta D Fitzgerald  3 , Pichaporn Artornsombudh  5 , Srishti Kothari  6 , Siddharth S Pujari  7 , Douglas A Jabs  8 , Grace A Levy-Clarke  9 , Robert B Nussenblatt  10 , James T Rosenbaum  11 , H Nida Sen  12 , Eric B Suhler  13 , Jennifer E Thorne  8 , Nirali P Bhatt  3 , C Stephen Foster  14 , Kurt A Dreger  15 , Jeanine M Buchanich  16 , John H Kempen  17 ; Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study Research Group
Affiliations

Incidence and Remission of Post-Surgical Cystoid Macular Edema Following Cataract Surgery in Eyes With Intraocular Inflammation

Sapna Gangaputra et al. Am J Ophthalmol. 2024 Nov.

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 to 44 years and aOR = 1.93 for ages 45 to 64 years, overall P = .02); concurrent use of systemic immunosuppression (conventional aOR 1.53 and biologics aOR = 2.68, overall P = .0095); preoperative VA 20/50 or worse (overall P < .0001); cataract surgery performed before 2000 (overall P = .03) and PMCE in fellow eye (aOR = 3.04, P = .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.

PubMed Disclaimer

Conflict of interest statement

Potential Conflict of Interest:

  1. Sapna S. Gangaputra: National Eye Institute (Grant support); Research to Prevent Blindness (grant support, unrestricted department grant)

  2. Sylvia L. Groth: Olleyes (Grant support)

  3. Douglas A. Jabs: Abbvie (Research Funding)

  4. Grace A. Levy-Clarke: Abbvie (Consultant, Lecture Fees); Allergan (Grant Support); Mallinckrodt (Consultant, Grant Support); Sanofi (Grant Support; Lecture Fees)

  5. James T. Rosenbaum: Corvus Pharmaceuticals (Employment); Abbvie (Consultant); Gilead (Consultant); Janssen (Consultant); Eyevensys (Consultant); UpToDate (Consultant); Pfizer (Financial Support); Novartis (Consultant); Roche (Consultant); Alcon Research Institute (Financial Support); UCB (consultant); Horizon (Consultant and financial support); Santen (consultant); Celgene (Consultant); Pfizer (Education); UCB (Consultant).

  6. Eric B. Suhler: Eyevensys (Consultant); Santen (Consultant); EyeGate (Consultant, Financial Support); Abbvie (Consultant, Financial Support); Clearside (Consultant, Financial Support); EyePoint (Consultant, Financial Support)

  7. Jennifer E. Thorne: Abbvie (Consultant); Canfield (Consultant); Clearside (Consultant); Gilead (Consultant); Guidepoint (Consultant); Roche (Consultant); Tarsier Pharma (Scientific Advisory Board; Equity Owner); UptoDate (Consultant); F. Hoffmann-La Roche AG (consultant)

  8. C. Stephen Foster: Aldeyra (Consultant, Grant Support), Allakos (Consultant), Bausch & Lomb (Consultant, Grant Support), Eyegate (Consultant, Grant Support, Stock), Genentech (Consultant), Novartis (Consultant, Grant Support), pSivida (Consultant, Grant Support), Aciont (Grant Support), Alcon (Grant Support, Lecture Fees), Clearside (Grant Support), Dompé (Grant Support), Mallinckrodt (Grant Support, Lecture Fees), Allergan (Lecture Fees).

  9. John H. Kempen: Betaliq (Equity Owner); Tarsier Pharma (Equity Owner).

  10. The other authors indicate no potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Kaplan Meier curves depicting time to onset of post-surgical cystoid macular edema with visual acuity 20/50 or worse, by anatomic location of uveitis. In the X axis, the whole number indicates the number of eyes at risk at that time point, and the number in parenthesis records the cumulative number of events up to that timepoint. Hazard ratio for intermediate uveitis (HR 1.00, 95% confidence interval 0.71–1.40, p=0.99) and posterior/panuveitis (HR 1.25, 95% confidence interval 1.00–1.58, p=0.05), as compared to anterior uveitis.
Figure 2.
Figure 2.
Kaplan Meier curves depicting time to resolution of post-surgical cystoid macular edema with visual acuity 20/40 or better sustained across 90 days, by anatomic location of uveitis. In the X axis, the whole number indicates the number of eyes at risk at that time point, and the number in parenthesis records the cumulative number of events up to that timepoint. Hazard ratio for intermediate uveitis (HR 1.21, 95% confidence interval 0.84–1.75, p=0.31) and posterior/panuveitis (HR 0.96, 95% confidence interval 0.71–1.30, p=0.78), as compared to anterior uveitis
Figure 3.
Figure 3.
Kaplan Meier curves depicting time to relapse of post-surgical cystoid macular edema with visual acuity 20/50 or worse sustained across 90 days, among eyes that had prior resolution, by anatomic location of uveitis. In the X axis, the whole number indicates the number of eyes at risk at that time point, and the number in parenthesis records the cumulative number of events up to that timepoint. Hazard ratio for intermediate uveitis (HR 0.92, 95% confidence interval 0.24–3.47, p=0.90) and posterior/panuveitis (HR 1.29, 95% confidence interval 0.54–3.08, p=0.57), as compared to anterior uveitis
See this image and copyright information in PMC

References

    1. Irvine SR A newly defined vitreous syndrome following cataract surgery. Am. J. Ophthalmol. 1953;36:599–619. - PubMed
    1. Gass JD, Norton EW Cystoid macular edema and papilledema following cataract extraction. A fluorescein fundoscopic and angiographic study. Arch. Ophthalmol. 1966;76:646–661. - PubMed
    1. Orski M, Gawęcki M. Current Management Options in Irvine-Gass Syndrome: A Systemized Review. J Clin Med. 2021. Sep 25;10(19):4375. - PMC - PubMed
    1. Perente I, Utine CA, Ozturker C, Cakir M, Kaya V, Eren H, Kapran Z, Yilmaz OF Evaluation of macular changes after uncomplicated phacoemulsification surgery by optical coherence tomography. Curr. Eye Res. 2007;32:241–247. - PubMed
    1. Kusbeci T, Eryigit L, Yavas G, Inan UU. Evaluation of cystoid macular edema using optical coherence tomography and fundus fluorescein angiography after uncomplicated phacoemulsification surgery. Curr Eye Res. 2012. Apr;37(4):327–33. - PubMed

MeSH terms