Preoperative central macular thickness as a risk factor for pseudophakic macular edema.

Abstract

This study aims to determine whether elevated central macular thickness (CMT) before uncomplicated cataract surgery may be a risk factor for developing cystic macular edema (CMEs) as measured by Cirrus-OCT and defined as the presence of macular intraretinal cysts. A prospective study in Hospital Universitario Poniente, Almeria, Spain, where 379 patients were included for optical coherence tomography (OCT) before cataract surgery, the following day, at 1month and at 3months and the presence of macular intraretinal cysts assessed by OCT. Patients with known risk factors for developing CME and patients who developed major surgical complications were excluded. One hundred seventy-nine patients completed the study. The pre-surgical CMT was 257.75 (20.60) μm measured by Cirrus-OCT. After 1month, there was an average increase in CMT of 277.86 (45.29) μm, and this increase in thickness decreased after 3months to an average value of 267.86 (20.17) μm. There were 10.34% of patients with cysts in some of the controls after surgery. This study proposes a binary logistic model to predict the presence of CME depending on the pre-surgery CMT. The cut-off point was 260.5μm. Patients with pre-surgical macular thickness > 260.5μm measured by Cirrus- OCT before cataract surgery, no known risk factors for developing CME and no major surgical complications presented 9.08 times more probability to develop macular intraretinal cysts after uncomplicated cataract surgery.