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Intraoperative subconjunctival steroid reduces the incidence of pseudophakic macular oedema: a cohort study of 20,066 consecutive phacoemulsification surgeries

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Abstract

Background/Objectives

Pseudophakic macular oedema remains the most common sight-threatening complication following cataract surgery. This study aims to assess the effect of intraoperative subconjunctival steroids on the rate of pseudophakic cystoid macular oedema.

Methods

A retrospective, observational database study of 20 066 consecutive phacoemulsification surgeries. The incidence of pseudophakic cystoid macular oedema was compared in eyes that did and did not receive intraoperative subconjunctival steroid injection during routine cataract surgery.

Results

Intraoperative subconjunctival injection of dexamethasone or betamethasone sodium phosphate significantly reduced the odds of developing pseudophakic cystoid macular oedema across the cohort (odds ratio: 0.67; 95% confidence interval: 0.46–0.98, p = 0.039). The effect of subconjunctival steroids on pseudophakic macular oedema remained independently associated on multivariate logistic regression analysis (p = 0.028).

Conclusion

This study demonstrates that administration of intraoperative subconjunctival steroid injection is associated with a reduced incidence of pseudophakic cystoid macular oedema in routine, uncomplicated cataract surgery.

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Fig. 1: Bar chart depicting the incidence of pseudophakic macular oedema (PCMO) with the use of subconjunctival steroids (SCS) versus no SCS : A reduction of incidence of PCMO is seen with the use of SCS across all groups.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Epsom and St Helier NHS Trust, London, UK

    Michelle Ai Ling Teo, Ramu Muniraju & Paul Ursell

  2. NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK

    Edward Bloch

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Contributions

MALT was responsible for designing the study, data collection, analysis and interpretation, literature review, and writing the report. EB was responsible for the statistical analysis and interpretation, providing continuous and final review of the report. PU was responsible for the conception of the study and review of the report. RM provided feedback on the report.

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Correspondence to Michelle Ai Ling Teo.

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Teo, M.A.L., Bloch, E., Muniraju, R. et al. Intraoperative subconjunctival steroid reduces the incidence of pseudophakic macular oedema: a cohort study of 20,066 consecutive phacoemulsification surgeries. Eye 37, 2077–2081 (2023). https://doi.org/10.1038/s41433-022-02290-1

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