Incidence and risk factors of cystoid macular edema after retinal detachment surgery

Abstract

PurposeTo evaluate the incidence rate of cystoid macular edema (CME) after uncomplicated primary operation on retinal detachment (RD) and to identify risk factors associated with postoperative CME.MethodsRetrospective interventional case series of consecutive patients that underwent one RD repair either by primary vitrectomy or external procedure during a 3 years period starting on January 2012. Postoperative CME was defined as poor visual recovery associated with intraretinal hyporeflective cysts on optical coherent tomography scans (OCT) engendering central macular thickening.ResultsA total of 403 eyes were studied with a mean follow‐up of 6 months. The incidence of CME was 7% after pars plana vitrectomy (22/317 eyes) and 2.3% after external procedure (2/86 eyes). Risk factors for CME were : a smaller axial length (p < 0.005), a higher duration of macular detachment (p < 0.029), a lower visual acuity at presentation (p < 0.022), an history of posterior capsular rupture (p < 0.01) and the use of cryopexy during surgery (p = 0.035). After 6 month follow‐up CME persisted in 12/24 patients. Mean visual acuity was 0.28 logMAR in eyes without CME versus 0.4 logMAR in eyes with persistent CME.ConclusionsThe incidence of CME after RD repair was 7% after primary vitrectomy, and 2.3% after primary scleral buckling. Patients might benefit from increase use of OCT during follow‐up of retinal detachment surgery to detect macular pathology. Visual prognosis was good in 50% patients.