American Journal of Ophthalmology 2013-02-01

Macular edema following cataract surgery in eyes with previous 23-gauge vitrectomy and peeling of the internal limiting membrane.

Georgios Mylonas, Stefan Sacu, Gábor Deák, Roman Dunavoelgyi, Wolf Buehl, Michael Georgopoulos, Ursula Schmidt-Erfurth

Index: Am. J. Ophthalmol. 155(2) , 253-259.e2, (2013)

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Abstract

To investigate intraretinal changes after successful cataract surgery in patients with previous pars plana vitrectomy (PPV) and indocyanine green-assisted peeling of epiretinal membrane and internal limiting membrane (ILM).Prospective nonrandomized controlled clinical study.Twenty eyes of 20 patients with cataract with previous 23-gauge PPV and ILM peeling (PPV group) and 15 consecutive eyes with senile cataract with a healthy macula (control group) were included. Best-corrected visual acuity (BCVA), spectral-domain optical coherence tomography (OCT), infrared fundus imaging, and biomicroscopy were performed at baseline and at week 1, month 1, and month 3 after cataract surgery. OCT raster scans were further analyzed regarding the central millimeter thickness (CMMT), area of retinal thickening size on the topographic map, and changes in retinal structural morphology.The baseline mean visual acuity in the PPV group was 0.3 ± 0.18 Snellen lines, which improved significantly to 0.85 ± 0.18 (P < .05) 3 months after cataract surgery. CMMT was 393 (± 44) μm at baseline and increased to 408 (± 47) μm at month 3 (P < .05). One patient was not seen at the final visit, so data of 19 patients was used. In the PPV group, 8 of 19 patients (42%) developed an increase in CMMT more than 35 μm 1 month after cataract surgery; 5 of these 8 patients (26%) developed macular edema with cyst formation. Three months after surgery, the area of retinal thickening was significantly larger in most patients compared with baseline values. No cystoid macular edema was observed in the control group.This study provides evidence that patients with previous PPV and membrane and ILM peeling often develop macular edema after successful cataract surgery.Copyright © 2013 Elsevier Inc. All rights reserved.