Pseudophakic cystoid macular edema and spectral-domain optical coherence tomography–detectable central macular thickness changes with perioperative prostaglandin analogs

Abstract

To define the incidence of cystoid macular edema (CME) and spectral-domain optical coherence tomography-detectable (SD-OCT) subclinical changes in central retinal thickness in patients using prostaglandin analog (PGA) eyedrops after phacoemulsification. Royal Bolton Hospital, Bolton, United Kingdom. Prospective case series. A consecutive analysis of the incidence of postoperative CME after phacoemulsification by a single surgeon was performed in eyes of patients using PGA eyedrops between March 2010 and January 2014. The presence of CME was determined using SD-OCT (Cirrus) 3weeks and 6weeks postoperatively. Exclusion criteria included preexisting pathology known to predispose to CME and previous ophthalmic surgery. The paired Wilcoxon signed-rank test was used to compare central retinal thickness measurements at baseline and 3weeks and 6weeks postoperatively. All 48 patients (mean age 78.4years; 60 eyes) had uneventful surgery. There were no cases of clinically significant CME. Subclinical CME detected by SD-OCT was confirmed in 2eyes of different patients (3.3% of eyes), 1 eye 3weeks postoperatively and another eye at 6weeks. Subclinical CME resolved in both cases within 8weeks. In both cases, the difference in central retinal thickness at baseline and 6weeks postoperatively was statistically significant (P<.05). The incidence of subclinical CME detectable on SD-OCT after routine phacoemulsification in patients using PGA eyedrops throughout the perioperative period was 3.3%. There were no cases of clinical CME. These findings might guide clinicians in their decision to use PGAs perioperatively.