Risk Factors for Presence of Cystoid Macular Edema following Rhegmatogenous Retinal Detachment Surgery

ABSTRACT

Purpose: Cystoid macular edema (CME) following cataract surgery is a well-known entity. Less is known regarding the risk factors of developing CME following repair of rhegmatogenous retinal detachments (RRD).

Methods: This was a multi-institutional study of primary RRD surgeries from 1/1/2015 through 12/31/2015. The primary outcome was the development of postoperative CME following RRD surgery. Post-operative optical coherence tomography imaging and 3 months of follow-up following RRD repair were required.

Results: There were 1,466 eyes that met the inclusion criteria, and 140 (9.6%) developed postoperative CME following primary RRD repair. On multivariate analysis, the statistically significant metrics were older patient age (OR 1.03 per year, 95% CI 1.01 to 1.05), pre-operative proliferative vitreoretinopathy (PVR, OR 1.74, 95% 1.03 to 2.95), and cataract surgery following RRD repair (OR 2.18, 95% CI 1.47 to 3.25). Single surgery success was protective against CME (OR 0.20 (95% CI 0.14–0.30). Seventy-six (9.0%) of the phakic eyes and 60 (9.9%) of the pseudophakic eyes developed post-operative CME. Multivariate analysis showed that cataract surgery following RRD repair (p < .0001) for phakic eyes and older age (p = .0075) for pseudophakic eyes were risk factors. In eyes that underwent successful retinal reattachment with one surgery, post-operative cataract surgery (p = .0005) and pre-operative PVR (p = .0011) were risk factors for CME in this subgroup.

Conclusion: CME occurred in nearly 10% of the eyes following RRD repair. The biggest risk factors were recurrent RRD, preexisting PVR, older age, and cataract surgery following RRD repair.

KEYWORDS:

• Cystoid macular edema
• rhegmatogenous retinal detachment
• vitreoretinal surgery

Disclosure of potential conflicts of interest

Consultant for Alcon (CDR, DE, OG, YY), Grant support from Alcon (AC), royalties from Alcon (EHR), stockholder in Aldeyra Therapeutics (DE, CDR), consultant for Dutch Ophthalmic (DE), Scientific Advisory Board for Pykus Therapeutics (DE), stockholder in Valiant and Glaukos (GGE).

Data availability statement

There is no associated dataset.

Relevant disclosures

Consultant for Alcon (CDR, DE, OG, YY), Grant support from Alcon (AC), royalties from Alcon (EHR), stockholder in Aldeyra Therapeutics (DE, CDR), consultant for Dutch Ophthalmic (DE), Scientific Advisory Board for Pykus Therapeutics (DE), stockholder in Valiant and Glaukos (GGE).

Additional information

Funding

Phillips Eye Institute Foundation, Vitreo Retinal Surgery Foundation Vitreo Retinal Surgery Foundation; Phillips Eye Institute.