. 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 Gangaputra¹, Craig Newcomb², Gui-Shuang Ying³, Sylvia Groth⁴, Tonetta D Fitzgerald³, Pichaporn Artornsombudh⁵, Srishti Kothari⁶, Siddharth S Pujari⁷, Douglas A Jabs⁸, Grace A Levy-Clarke⁹, Robert B Nussenblatt¹⁰, James T Rosenbaum¹¹, H Nida Sen¹², Eric B Suhler¹³, Jennifer E Thorne⁸, Nirali P Bhatt³, C Stephen Foster¹⁴, Kurt A Dreger¹⁵, Jeanine M Buchanich¹⁶, John H Kempen¹⁷; Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study Research Group

Affiliations

¹ From the Vanderbilt Eye Institute (S.G., S.G.), Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: sapna.gangaputra@vumc.org.
² Center for Clinical Epidemiology and Biostatistics (C.N.), Department of Biostatistics and Epidemiology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Department of Ophthalmology (G.-S.Y., T.D.F., S.K., N.P.B., K.A.D.), The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ From the Vanderbilt Eye Institute (S.G., S.G.), Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁵ Department of Ophthalmology (P.A.), Somdech Phra Pinkloa Hospital, Royal Thai Navy, Bangkok, Thailand; Department of Ophthalmology (P.A.), Chulalongkorn University, Bangkok, Thailand.
⁶ Department of Ophthalmology (G.-S.Y., T.D.F., S.K., N.P.B., K.A.D.), The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; Massachusetts Eye Research and Surgery Institution (S.K., C.S.F.), Waltham, Massachusetts, USA.
⁷ Siddharth Netralaya Superspecialty Eye Hospital (S.S.P.), Belgaum, Karnataka, India.
⁸ Wilmer Eye Institute (D.A.J., J.E.T.), The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Center for Clinical Trials and Evidence Synthesis (D.A.J., J.E.T.), Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁹ Department of Ophthalmology and Visual Sciences (G.A.L.-C.), West Virginia University, Morgantown, West Virginia, USA.
¹⁰ Laboratory of Immunology (R.B.N.), National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
¹¹ Department of Ophthalmology (J.T.R., E.B.S.), Oregon Health and Science University, Portland, Oregon, USA; Department of Medicine (J.T.R.), Oregon Health and Science University, Portland, Oregon, USA; Legacy Devers Eye Institute (J.T.R.), Portland, Oregon, USA.
¹² Department of Ophthalmology (H.N.S.), George Washington University, Washington, DC, USA; Janssen Retina Global Clinical Development (H.N.S.), Princeton, New Jersey, USA.
¹³ Department of Ophthalmology (J.T.R., E.B.S.), Oregon Health and Science University, Portland, Oregon, USA; Portland Veteran's Affairs Medical Center (E.B.S.), Portland, Oregon, USA.
¹⁴ Massachusetts Eye Research and Surgery Institution (S.K., C.S.F.), Waltham, Massachusetts, USA; Department of Ophthalmology and Schepens Eye Research Institute (C.S.F., J.H.K.), Massachusetts Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
¹⁵ Department of Ophthalmology (G.-S.Y., T.D.F., S.K., N.P.B., K.A.D.), The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Population, Family, and Reproductive Health (K.A.D.), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
¹⁶ Center for Occupational Biostatistics and Epidemiology (J.M.B.), University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.
¹⁷ Department of Ophthalmology and Schepens Eye Research Institute (C.S.F., J.H.K.), Massachusetts Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Sight for Souls (J.H.K.), Bellevue, Washington, USA; MCM Eye Unit (J.H.K.), MyungSung Christian Medical Center (MCM) General Hospital and Myung Sung Medical School, Addis Ababa, Ethiopia; Department of Ophthalmology (J.H.K.), Addis Ababa University School of Medicine, Addis Ababa, Ethiopia. Electronic address: John_kempen@meei.harvard.edu.

PMID: 38880375
PMCID: PMC11486591 (available on 2025-11-01)
DOI: 10.1016/j.ajo.2024.06.006

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.

. 2024 Nov:267:182-191.

doi: 10.1016/j.ajo.2024.06.006. Epub 2024 Jun 15.

Authors

Affiliations

¹ From the Vanderbilt Eye Institute (S.G., S.G.), Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: sapna.gangaputra@vumc.org.
² Center for Clinical Epidemiology and Biostatistics (C.N.), Department of Biostatistics and Epidemiology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Department of Ophthalmology (G.-S.Y., T.D.F., S.K., N.P.B., K.A.D.), The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ From the Vanderbilt Eye Institute (S.G., S.G.), Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁵ Department of Ophthalmology (P.A.), Somdech Phra Pinkloa Hospital, Royal Thai Navy, Bangkok, Thailand; Department of Ophthalmology (P.A.), Chulalongkorn University, Bangkok, Thailand.
⁶ Department of Ophthalmology (G.-S.Y., T.D.F., S.K., N.P.B., K.A.D.), The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; Massachusetts Eye Research and Surgery Institution (S.K., C.S.F.), Waltham, Massachusetts, USA.
⁷ Siddharth Netralaya Superspecialty Eye Hospital (S.S.P.), Belgaum, Karnataka, India.
⁸ Wilmer Eye Institute (D.A.J., J.E.T.), The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Center for Clinical Trials and Evidence Synthesis (D.A.J., J.E.T.), Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁹ Department of Ophthalmology and Visual Sciences (G.A.L.-C.), West Virginia University, Morgantown, West Virginia, USA.
¹⁰ Laboratory of Immunology (R.B.N.), National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
¹¹ Department of Ophthalmology (J.T.R., E.B.S.), Oregon Health and Science University, Portland, Oregon, USA; Department of Medicine (J.T.R.), Oregon Health and Science University, Portland, Oregon, USA; Legacy Devers Eye Institute (J.T.R.), Portland, Oregon, USA.
¹² Department of Ophthalmology (H.N.S.), George Washington University, Washington, DC, USA; Janssen Retina Global Clinical Development (H.N.S.), Princeton, New Jersey, USA.
¹³ Department of Ophthalmology (J.T.R., E.B.S.), Oregon Health and Science University, Portland, Oregon, USA; Portland Veteran's Affairs Medical Center (E.B.S.), Portland, Oregon, USA.
¹⁴ Massachusetts Eye Research and Surgery Institution (S.K., C.S.F.), Waltham, Massachusetts, USA; Department of Ophthalmology and Schepens Eye Research Institute (C.S.F., J.H.K.), Massachusetts Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
¹⁵ Department of Ophthalmology (G.-S.Y., T.D.F., S.K., N.P.B., K.A.D.), The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Population, Family, and Reproductive Health (K.A.D.), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
¹⁶ Center for Occupational Biostatistics and Epidemiology (J.M.B.), University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.
¹⁷ Department of Ophthalmology and Schepens Eye Research Institute (C.S.F., J.H.K.), Massachusetts Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Sight for Souls (J.H.K.), Bellevue, Washington, USA; MCM Eye Unit (J.H.K.), MyungSung Christian Medical Center (MCM) General Hospital and Myung Sung Medical School, Addis Ababa, Ethiopia; Department of Ophthalmology (J.H.K.), Addis Ababa University School of Medicine, Addis Ababa, Ethiopia. Electronic address: John_kempen@meei.harvard.edu.

PMID: 38880375
PMCID: PMC11486591 (available on 2025-11-01)
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 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.

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Conflict of interest statement

Potential Conflict of Interest:

Sapna S. Gangaputra: National Eye Institute (Grant support); Research to Prevent Blindness (grant support, unrestricted department grant)
Sylvia L. Groth: Olleyes (Grant support)
Douglas A. Jabs: Abbvie (Research Funding)
Grace A. Levy-Clarke: Abbvie (Consultant, Lecture Fees); Allergan (Grant Support); Mallinckrodt (Consultant, Grant Support); Sanofi (Grant Support; Lecture Fees)
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).
Eric B. Suhler: Eyevensys (Consultant); Santen (Consultant); EyeGate (Consultant, Financial Support); Abbvie (Consultant, Financial Support); Clearside (Consultant, Financial Support); EyePoint (Consultant, Financial Support)
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)
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).
John H. Kempen: Betaliq (Equity Owner); Tarsier Pharma (Equity Owner).
The other authors indicate no potential conflicts of interest.

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

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

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