Prior retinal vein occlusion associated with increased risk of pseudophakic CME

Patients with a history of retinal vein occlusion, epiretinal membrane or prostaglandin use may have an increased risk of pseudophakic cystoid macular edema, according to a study by Massachusetts researchers. However, prophylactically treating high-risk patients using nonsteroidal anti-inflammatory drugs postoperatively decreases the edema incidence to that of normal-risk patients, the authors noted.

Bonnie A. Henderson, MD, and colleagues investigated the incidence and risk factors of cystoid macular edema (CME) after cataract surgery in 1,659 patients treated between 2001 and 2006. They published their results in the September issue of Journal of Cataract and Refractive Surgery.

Investigators classified patients according to the presence of and treatment for CME. They also performed a subset analysis that excluded diabetic patients.

The researchers found that a history of retinal vein occlusion was predictive of the development of CME postoperatively (P < .001). Overall, 39 of the 1,659 patients (2.35%) developed postop CME, the author reported.

After excluding patients with diabetes, CME occurred in 29 of the remaining 1,357 non-diabetic patients (2.14%). Among these patients, a history of retinal vein occlusion (P < .001), epiretinal membrane (P < .03) or preoperative use of prostaglandins (P < .04) was associated with the development of CME after surgery, according to the study.

However, "patients with [diabetes mellitus] and/or intraoperative complications did not have an increased risk for CME when treated with prophylactic postoperative NSAIDs for 3 months," the authors said.

"Treating high-risk patients with NSAIDs after cataract surgery decreases the incidence of postoperative CME to that of patients who are not at high risk," they said.

Also, CME resolved significantly faster among patients treated with both NSAIDs and a steroid after surgery compared with non-treated patients (P = .004), the authors noted.