Incidence and risk factors for cystoid macular edema following scleral buckling

Abstract

PurposeTo investigate the incidence of cystoid macular edema (CME) after scleral buckling (SB) and verify the possible risk factors of CME.MethodsA retrospective, non-comparative, interventional case series study was conducted. Clinical charts of 130 consecutive patients who were underwent successful SB for primary retinal detachment (RD) from 2009 to 2013 were reviewed. Optical coherence tomography (OCT) was applied to detect CME. Data pertaining to patient demographics, pre- and postoperative visual acuity, surgical procedures, and postoperative OCT findings were recorded. Factors associated with CME were also analyzed.ResultsThe incidence of CME was 9/130 (6.9%). Risk factors for developing CME were older age (non-CME vs CME: 44.8±14.8 vs 57.3±5.3 years, P<0.05), more extensive RD (RD extent by clock hours; non-CME vs CME: 4.61±1.57 vs 5.78±1.39, P<0.05), macular detachment (non-CME vs CME: 51.2 vs 88.9%, P<0.05), and external drainage (non-CME vs CME: 38.8% vs 77.8%, P<0.05). There was no significant difference between patient with and without CME regarding the use of gas tamponade and the lens status. In patients with more extensive RD (macular detachment plus RD of more than 3 clock hours before surgery), 8 of 68 patients had CME after SB and only older age and external drainage factors were associated with CME.ConclusionsThe risk factors associated with CME after SB were older age, more extended RD, macular detachment, and external drainage. External drainage should be used with caution in older patients with more extensive RD.

Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses

“…Eyes with CME had a greater number of surgeries, higher rates of PVR grade C and retinectomy, and higher rates of SO use. Many studies have shown increased inflammation and CME with more complicated ocular surgeries and inflammatory risk factors [ 3 , 11 , 20 ]. Re-detachments are frequently associated with PVR formation and warrant additional surgeries, both of which can increase intraocular inflammation and possible risk for CME [ 21 ].…”

“…Cryotherapy at our institution is only used during primary scleral buckling, usually for limited and uncomplicated detachments in phakic patients. While data comparing CME rates between PPV and SB are scant, the correlation between more complicated detachments and CME is consistent [ 3 , 11 , 18 ].…”

“…There is little data on post-RRD CME risk factors, rates, and anatomical characteristics [ 3 , 5 , 11 ]. Therefore, this observational study was designed to compare a consecutive case series of eyes with versus without post-RRD CME, with the aim to determine its risk factors and describe its clinical characteristics and therapeutic outcomes.…”

Macular optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment

“…Conversely, the prevalence after pneumatic retinopexy has been reported as low as 8% of cases. 80 Lai et al 81 investigated the risk factors associated with CME after scleral buckling, including older age, more extended RRD, macular detachment, and external drainage. The authors suggested that external drainage should be used with caution in older patients with extensive RRD.…”

Cystoid Macular Edema after Extracapsular Cataract Extraction Performed by Residents

“…Latanoprost usage for glaucoma treatment also increase the risk of macular edema after cataract surgery. Patient factors like age and sex, are also factors which affect development of CME 12 . According to Stern et al younger people are more prone to CME after cataract surgery 13 .…”