Preexisting epiretinal membrane is associated with pseudophakic cystoid macular edema

  • Friederike Schaub
  • Werner Adler
  • Philip Enders
  • Meike C. Koenig
  • Konrad R. Koch
  • Claus Cursiefen
  • Bernd Kirchhof
  • Ludwig M. Heindl
Retinal Disorders



The purpose of the present study was to evaluate whether preexisting epiretinal membrane (ERM) is a significant risk factor for developing pseudophakic cystoid macular edema (PCME).


Two hundred four consecutive eyes and 153 consecutive eyes without preexisting epiretinal membranes were retrospectively compared regarding PCME development following phacoemulsification with posterior chamber lens implantation. Patients with vascular retinal diseases, uveitis, trauma, neovascular macular degeneration, chronic inflammatory conditions, diabetic retinopathy, endophthalmitis, eventful cataract surgery, and combination of cataract surgery and vitrectomy during the observation period were excluded. Macular examination was performed using spectral-domain optical coherence tomography (SD-OCT) before as well as at 4, 8, 12, 16, 24, and 36 weeks after cataract surgery. Univariate and multivariate logistic regression analyses were calculated.


PCME occurred in 32 of 204 eyes with preexisting ERM (15.7%), whereas 9 of 153 eyes without preexisting ERM (5.9%) developed PCME. The risk of PCME was significantly increased in eyes with ERM (p = 0.007). By multivariate logistic regression analysis, factors predictive of PCME included the history of previous pars plana vitrectomy for retinal detachment (odds ratio (OR) 3.619 [95% confidence interval (CI) 1.242 to 10.258]; p = 0.016) as well as the preexistence of ERM (OR 3.885 [95% CI 1.162 to 17.762]; p = 0.04).


Preexisting ERM seems to be associated with an increased risk of PCME following cataract surgery. Therefore, this risk should be considered in surgery planning, preoperative medication, and follow-up care after surgery.


Epiretinal membrane Cystoid macular edema Cataract Phacoemulsification Complication 



This research was supported by German Research Foundation FOR 2240 “(Lymph) Angiogenesis And Cellular Immunity In Inflammatory Diseases Of The Eye” to CC and LMH ( The sponsor had no role in the design or implementation of this research.

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Friederike Schaub
    • 1
  • Werner Adler
    • 2
  • Philip Enders
    • 1
  • Meike C. Koenig
    • 1
  • Konrad R. Koch
    • 1
  • Claus Cursiefen
    • 1
  • Bernd Kirchhof
    • 1
  • Ludwig M. Heindl
    • 1
  1. 1.Department of OphthalmologyUniversity of CologneCologneGermany
  2. 2.Department of Medical Informatics, Biometry and EpidemiologyFriedrich-Alexander University Erlangen-NürnbergErlangenGermany

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