Literature DB >> 16931266

Cystoid macular edema after pars plana vitrectomy for retained lens fragments.

Steven M Cohen1, Aaron Davis, Chris Cukrowski.   

Abstract

PURPOSE: To describe the incidence and clinical course in patients with cystoid macular edema (CME) following pars plana vitrectomy (PPV) for retained lens fragments.
SETTING: Retina group, private practice.
METHODS: This retrospective study reviewed the medical records of 91 patients who had PPV for retained lens fragments. The patients were followed for at least 6 months. Patients with concomitant eye diseases that adversely affected macular examination or macular function were excluded.
RESULTS: Four (8%) of 50 eyes with a sulcus-fixated posterior chamber intraocular lens (PC IOL) implanted at cataract extraction and 19 (46%) of 41 eyes with aphakia or an anterior chamber IOL developed CME (P</=.001, chi-square test). The CME developed a mean of 4 months after PPV. Treatment consisted of steroid eyedrops in all eyes; 17 eyes were also treated with a topical cyclooxygenase inhibitor, and 5 eyes received posterior sub-Tenon's steroid injections. The CME resolved a mean of 2 months after 1 treatment course in 12 eyes, which had a final visual acuity of 20/40 or better. The CME resolved, recurred, and then resolved in 6 eyes. In these eyes, the first incidence lasted a mean of 4 months. The second episode occurred a mean of 5 months after the initial episode resolved and took a mean of 3 months to resolve. Final visual acuity was 20/40 or better in 5 of these eyes. The CME persisted in 5 eyes that were followed for a mean of 30 months. None of these eyes had an acuity of 20/40 or better.
CONCLUSIONS: Sulcus placement of a PC IOL at cataract extraction was associated with a reduced risk for CME. The prognosis for eyes that develop CME after PPV for retained lens fragments is guarded. Long-term therapy should be considered because of the high rate of recurrence.

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Year:  2006        PMID: 16931266     DOI: 10.1016/j.jcrs.2006.04.019

Source DB:  PubMed          Journal:  J Cataract Refract Surg        ISSN: 0886-3350            Impact factor:   3.351


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