Association of Postoperative Topical Prostaglandin Analog or Beta-Blocker Use and Incidence of Pseudophakic Cystoid Macular Edema

Abstract

To the best of our knowledge this is the largest study that has investigated the association between postoperative topical PGA or topical beta-blocker use and the incidence of pseudophakic CME. Postoperative use of both topical PGAs and topical beta-blockers was found to be associated with the incidence of pseudophakic CME.

The incidence and management of persistent cystoid macular oedema following uncomplicated cataract surgery—a Scottish Ophthalmological Surveillance Unit study

“…Use of topical prostaglandin analogues has been implicated in increasing the risk of CMO [8,12]. A small case series of randomised patients to topical prostaglandin analogues (bimatoprost, latanoprost, and travoprost) noted 6 (12.5%) patients subsequently developed angiographic CMO, although only one had an associated loss of visual acuity [25].…”

“…Wendel et al showed that apart from prostaglandin analogues, topical beta-blockers are also associated with the development of pseudophakic CMO. Through analysis of 508 cases and 5080 controls, they found the incidence of pseudophakic CMO to be statistically significantly associated with the current postoperative use of both topical PGAs [relative risk (RR), 1.86; 95% confidence interval (CI), 1.04-3.32] and topical betablockers (RR, 2.64; 95% CI, 1.08-6.49) [8].…”

“…CMO can also occur in the setting of uncomplicated cataract surgery, with published incidence rates ranging from 1.2-3.4% [5][6][7][8][9][10]. Known as Irvine-Gass syndrome for the past 60 years, patients commonly experience good A version of this study was an oral presentation at the Scottish Ophthalmological Club meeting in February 2020, accepted as a poster presentation at RCOphth Annual Congress, Birmingham, UK in May 2020 (postponed due to COVID-19 restrictions) and has been submitted as an oral presentation at the ESCRS annual meeting, Amsterdam, October 2020. vision in the immediate post-operative period, followed by a painless central visual deterioration a few weeks later [7].…”

Cystoid macular oedema following cataract surgery: A review

“…Other studies have identified preoperative prostaglandin use to be associated with increased risk of PCMO and a recent study of 508 cases and 5080 controls noted postoperative use of topical prostaglandins and beta‐blockers were both associated with increased incidence of PCMO. Interestingly, a prospective study of 70 patients with primary open angle glaucoma (POAG) and 68 healthy control eyes also reported that the risk of PCMO was greatest in the POAG group with prostaglandin analogue use (odds ratio 5.51).…”

“…However, just as the preceding evidence appears to be compelling in the indictment of prostaglandin analogues in the development of PCMO, 13,[26][27][28] in contrast, a large retrospective study including 3394 eyes with prostaglandin analogue use 12 reported no significant increase in risk of PCMO with topical prostaglandin analogues. Furthermore, Law et al 24 also observed that the use of preoperative and postoperative glaucoma medications was not associated with clinical CMO in a study of 700 eyes with glaucoma undergoing cataract surgery.…”