Preoperative central macular thickness as a risk factor for pseudophakic macular edema

Alferez-Asenjo, M L; Quereda-Castañeda, A.; Castro-Luna, Gracia

doi:10.1007/s00417-020-04862-x

Cited by 6 publications

(5 citation statements)

References 28 publications

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“…PCME rates did not differ significantly between the groups (15.4 vs. 19.5%, P ¼ 0.287) but incidence was much higher (29.40 vs. 16.30%, P ¼ 0.008) in eyes with baseline CRT at least 500 mm [59]. This is actually similar to the recent Doncel-Fernandez et al's findings: central macular thickness (CMT) greater than 260.5 mm measured by OCT before cataract surgery presented 9.08 times more probability to develop macular intraretinal cysts after uncomplicated cataract surgery [60].…”

Section: Flacs Causes Greater Inflammation Than Conventional Phacoemu...supporting

confidence: 85%

Management of inflammation after the cataract surgery

Grzybowski

Sidaraitė

Žemaitienė

2022

Current Opinion in Ophthalmology

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Purpose of reviewTo review most recent studies and clinical trials regarding pathogenesis, treatment, and prevention of inflammation after the cataract surgery.Recent findings FLACS gave opportunity to evaluate inflammatory cytokines in the aqueous humour right after the laser procedure, which led to acknowledging the inflammation pathogenesis during the phacoemulsification. Although there is still a lack of evidence, which would prove the long-term benefit of NSAIDs, they are indicated and effective when risk factors for PCME are present. PREMED studies showed that combination of NSAID and steroids after the surgery for healthy subjects is cost-effective. The triamcinolone injection together with topical steroids and NSAIDs for diabetic patients after the cataract surgery was the most costeffective in preventing PCME according to the PREMED. Dropless cataract surgery is another emerging topic: dexamethasone implants and suspensions look promising as we await more clinical trials with drugloaded IOLs.

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Section: Flacs Causes Greater Inflammation Than Conventional Phacoemu...supporting

confidence: 85%

Management of inflammation after the cataract surgery

Grzybowski

Sidaraitė

Žemaitienė

2022

Current Opinion in Ophthalmology

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“…Doncel-Fernández et al reported that patients without known risk factors for developing CME and major surgical complication presented 9.08 times more probability to develop pseudophakic ME when with a preoperative central macular thickness > 260.5 µm. 15 In the present study, a thicker preoperative CRT was also found to be associated with PV-DME.…”

Section: Discussionsupporting

confidence: 63%

The change of diabetic macular edema post vitrectomy in patients with proliferative diabetic retinopathy

Zhou¹,

Mei²,

Lin³

et al. 2023

Preprint

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Purpose To investigate the change of diabetic macular edema (DME) post vitrectomy and its risk factors.Methods Retrospective study design. This study included 365 eyes of 330 patients who underwent vitrectomy for proliferative diabetic retinopathy with gradable optical coherence tomography imaging from January 2018 to March 2022. The incidence of post vitrectomy DME (PV-DME) was defined as patients with a central retinal thickness (CRT) > 300 µm by optical coherence tomography among patients without preoperative DME.Results The cumulative incidence of PV-DME at 3 months was 40.1% (89/222), with its majority subtype of single diffused retinal thickening (66.2%) followed by single cystoid macular edema (27.0%). Multivariate Cox regression analysis indicated that a thicker preoperative CRT (HR = 1.01, 95% CI 1.00–1.02) and intraoperative internal limiting membrane peeling (HR = 3.18, 95% CI 1.85–5.47) were associated with the presence of PV-DME, while intraoperative intravitreal injection of triamcinolone acetonide (HR = 0.28, 95% CI 0.13–0.57) was protective against PV-DME. In eyes with preoperative DME (n = 143), the CRT decreased gradually from 468.3 ± 177.7 µm preoperatively to 409.5 ± 151.0 µm (P = 0.027), 377.4 ± 141.9 µm (P < 0.001), and 368.0 ± 157.6 µm (P < 0.001) at 7 days, 1 month, and 3 months postoperatively, respectively. Multivariate linear regression analysis indicated that only a thicker preoperative CRT (β = 0.77, 95% CI 0.63–0.92) was associated with a decreasing postoperative CRT.Conclusion PV-DME is a very common postoperative complication in patients with proliferative diabetic retinopathy. Triamcinolone acetonide could prevent its formation. Attention should be paid to patients with a thicker preoperative CRT and internal limiting membrane peeling.

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“…Collaborating researchers, such as Doncel-Fernandez CJ et al [6], published a prospective study of 174 patients and demonstrated that a preoperative CMT > 260.5 µm increased the probability of intraretinal cysts one month after cataract surgery compared to that in patients with preoperative CMT < 260.50 µm.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, as mentioned above, we detected lower GCLT and lower BCVA one month after surgery, with values of 69.93 (22.41) µm in patients with PMCE than in those without PMCE (80.12 (8.41) µm). Collaborating researchers, such as Doncel-Fernandez CJ et al [ 6 ], published a prospective study of 174 patients and demonstrated that a preoperative CMT > 260.5 μm increased the probability of intraretinal cysts one month after cataract surgery compared to that in patients with preoperative CMT < 260.50 μm.…”

Section: Discussionmentioning

confidence: 99%

“…A recently demonstrated risk factor is a central macular thickness >260. 5 µm measured with OCT before cataract surgery, which increases the probability of developing intraretinal cysts by 9.08 times [6]. Some studies have demonstrated that alterations of the ganglion cell layer thickness (GCLT), inner nuclear layer (INL), and Muller cells layer are produced in PCME with posterior GCL atrophy.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the Retinal Ganglion Cell Layer after Uncomplicated Cataract Surgery

Abou-Jokh Rajab,

Doncel-Fernández,

Sánchez-Liñan

et al. 2024

JCM

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(1) Background: This research aimed to evaluate the changes in ganglion cell layer thickness (GCLT) after uncomplicated cataract surgery in patients without previous ocular pathology and the impact of the appearance of cystoid macular edema on the GCLT and visual acuity. (2) Methods: The evaluation of 174 patients was performed with the indication of uncomplicated cataract surgery. The variables analyzed were demographic data, best-corrected visual acuity (BCVA), cataract type and OCT (Optical Coherence Tomography) measurements of central macular thickness (CMT), and the presence of cysts and GCLT preoperatively and one day, one and three months after surgery. (3) Results: There was a relationship between the postoperative increase in retinal GCLT and BCVA after uncomplicated cataract surgery. The presence of microcysts reduced the thickness of the GCL, which is significantly related to the loss of BCVA. The appearance of cystoid macular edema one month after surgery was also related to the preoperative CMT. There was a statistically significant decrease in preoperative GCL but a statistically significant increase in preoperative CMT in patients with microcysts one-month post-surgery. (4) Conclusions: There is a relationship between postoperative retinal GCLT and BCVA after uncomplicated cataract surgery. The presence of microcysts significantly reduces the thickness of the GCL, which is significantly related to the loss of BCVA.

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Preoperative central macular thickness as a risk factor for pseudophakic macular edema

Cited by 6 publications

References 28 publications

Management of inflammation after the cataract surgery

Management of inflammation after the cataract surgery

The change of diabetic macular edema post vitrectomy in patients with proliferative diabetic retinopathy

Assessment of the Retinal Ganglion Cell Layer after Uncomplicated Cataract Surgery

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