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Cataract surgery may increase risk of reopening closed macular holes
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Performing cataract surgery after successfully closing a macular hole by vitrectomy may increase the risk of the macular hole reopening, according to a study by researchers in Cleveland. Eyes that develop post-cataract surgery cystoid macular edema may be particularly at risk, the study authors noted.
Pawan Bhatnagar, MD, and colleagues at Cole Eye Institute reviewed outcomes for 211 eyes that had idiopathic macular holes closed by vitrectomy. The researchers divided the eyes into four groups. The first group included 56 eyes that underwent cataract extraction before vitrectomy. The second group included 86 eyes that underwent cataract extraction after vitrectomy. The third group included 41 eyes that underwent vitrectomy only, and the fourth group included 28 eyes that underwent vitrectomy and cataract extraction as a combined procedure, according to the study.
At 26.6 months mean follow-up, 24 macular holes (11%) had reopened.
Most reopenings occurred in the second group, which was treated with vitrectomy before cataract surgery. This group had a four-fold increased risk of macular hole reopening, which occurred in 17 of the 86 eyes (20%) included in the group, the authors reported.
In addition, researchers observed a seven-fold increased risk of reopening among eyes that developed cystoid macular edema after cataract extraction.
No association was found between the duration of the macular hole, serum use, internal limiting membrane peeling, or stage and macular hole reopening, they noted.
The study is published in the August issue of American Journal of Ophthalmology.