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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
  • 177 Downloads

Abstract

Purpose

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).

Methods

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.

Results

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).

Conclusion

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.

Keywords

Epiretinal membrane Cystoid macular edema Cataract Phacoemulsification Complication 

Notes

Funding

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 (www.for2240.de). 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.

References

  1. 1.
    Gass JD, Norton EW (1966) Cystoid macular edema and papilledema following cataract extraction. A fluorescein fundoscopic and angiographic study. Arch Ophthalmol 76:646–661CrossRefPubMedGoogle Scholar
  2. 2.
    Irvine AR (1976) Cystoid maculopathy. Surv Ophthalmol 21:1–17CrossRefPubMedGoogle Scholar
  3. 3.
    Gulkilik G, Kocabora S, Taskapili M, Engin G (2006) Cystoid macular edema after phacoemulsification: risk factors and effect on visual acuity. Can J Ophthalmol 41:699–703CrossRefPubMedGoogle Scholar
  4. 4.
    Perente I, Utine CA, Ozturker C, Cakir M, Kaya V, Eren H, Kapran Z, Yilmaz OF (2007) Evaluation of macular changes after uncomplicated phacoemulsification surgery by optical coherence tomography. Curr Eye Res 32:241–247CrossRefPubMedGoogle Scholar
  5. 5.
    Henderson BA, Kim JY, Ament CS, Ferrufino-Ponce ZK, Grabowska A, Cremers SL (2007) Clinical pseudophakic cystoid macular edema. Risk factors for development and duration after treatment. J Cataract Refract Surg 33:1550–1558CrossRefPubMedGoogle Scholar
  6. 6.
    Hunter AA, Modjtahedi SP, Long K, Zawadzki R, Chin EK, Caspar JJ, Morse LS, Telander DG (2014) Improving visual outcomes by preserving outer retina morphology in eyes with resolved pseudophakic cystoid macular edema. J Cataract Refract Surg 40:626–631CrossRefPubMedGoogle Scholar
  7. 7.
    Vukicevic M, Gin T, Al Qureshi S (2012) Prevalence of optical coherence tomography-diagnosed postoperative cystoid macular oedema in patients following uncomplicated phaco-emulsification cataract surgery. Clin Exp Ophthalmol 40:282–287CrossRefPubMedGoogle Scholar
  8. 8.
    Bringmann A, Reichenbach A, Wiedemann P (2004) Pathomechanisms of cystoid macular edema. Ophthalmic Res 36:241–249CrossRefPubMedGoogle Scholar
  9. 9.
    Lobo C (2012) Pseudophakic cystoid macular edema. Ophthalmologica 227:61–67CrossRefPubMedGoogle Scholar
  10. 10.
    Chu CJ, Johnston RL, Buscombe C, Sallam AB, Mohamed Q, Yang YC (2016) Risk factors and incidence of macular edema after cataract surgery: a database study of 81984 eyes. Ophthalmology 123:316–323CrossRefPubMedGoogle Scholar
  11. 11.
    Anastasilakis K, Mourgela A, Symeonidis C, Dimitrakos SA, Ekonomidis P, Tsinopoulos I (2015) Macular edema after uncomplicated cataract surgery: a role for phacoemulsification energy and vitreoretinal interface status? Eur J Ophthalmol 25:192–197CrossRefPubMedGoogle Scholar
  12. 12.
    Arcieri ES, Santana A, Rocha FN, Guapo GL, Costa VP (2005) Blood-aqueous barrier changes after the use of prostaglandin analogues in patients with pseudophakia and aphakia: a 6-month randomized trial. Arch Ophthalmol 123:186–192CrossRefPubMedGoogle Scholar
  13. 13.
    Sacchi M, Villani E, Gilardoni F, Nucci P (2014) Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature. Clin Ophthalmol 8:1253–1257CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Meuer SM, Myers CE, Klein BE, Swift MK, Huang Y, Gangaputra S, Pak JW, Danis RP, Klein R (2015) The epidemiology of vitreoretinal interface abnormalities as detected by spectral-domain optical coherence tomography: the beaver dam eye study. Ophthalmology 122:787–795CrossRefPubMedGoogle Scholar
  15. 15.
    Heo MS, Kim HW, Lee JE, Lee SJ, Yun IH (2012) The clinical features of macular pucker formation after pars plana vitrectomy for primary rhegmatogenous retinal detachment repair. Korean J Ophthalmol 26:355–361CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Odrobina D, Bednarski M, Cisiecki S, Michalewska Z, Kuhn F, Phd JN (2012) Internal limiting membrane peeling as prophylaxis of macular pucker formation in eyes undergoing retinectomy for severe proliferative vitreoretinopathy. Retina 32:226–231CrossRefPubMedGoogle Scholar
  17. 17.
    Khokhar AR, Rab KF, Akhtar HU (2003) Management of macular pucker. J Coll Physicians Surg Pak 13:701–703PubMedGoogle Scholar
  18. 18.
    Trese M, Chandler DB, Machemer R (1983) Macular pucker. II. Ultrastructure. Graefes Arch Clin Exp Ophthalmol 221:16–26CrossRefPubMedGoogle Scholar
  19. 19.
    McCafferty S, Harris A, Kew C, Kassm T, Lane L, Levine J, Raven M (2017) Pseudophakic cystoid macular edema prevention and risk factors; prospective study with adjunctive once daily topical nepafenac 0.3% versus placebo. BMC Ophthalmol 17:16CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Dietlein TS, Kohnen T, Rosentreter A, Lappas A (2013) Cataract surgery in glaucoma patients. Perioperative aspects. Ophthalmologe 110:316–320CrossRefPubMedGoogle Scholar
  21. 21.
    Dietlein TS, Widder RA, Jordan JF, Jonescu-Cuypers C, Rosentreter A (2013) Combined cataract and glaucoma surgery. Current options. Ophthalmologe 110:310–315CrossRefPubMedGoogle Scholar
  22. 22.
    Jacobi PC, Dietlein TS, Krieglstein GK (1998) Bimanual trabecular aspiration in pseudoexfoliation glaucoma: an alternative in nonfiltering glaucoma surgery. Ophthalmology 105:886–894CrossRefPubMedGoogle Scholar
  23. 23.
    Widder RA, Dinslage S, Rosentreter A, Jordan JF, Kuhnrich P, Cursiefen C, Lemmen KD, Dietlein TS (2014) A new surgical triple procedure in pseudoexfoliation glaucoma using cataract surgery, trabectome, and trabecular aspiration. Graefes Arch Clin Exp Ophthalmol 252:1971–1975CrossRefPubMedGoogle Scholar
  24. 24.
    Browning DJ, Glassman AR, Aiello LP, Bressler NM, Bressler SB, Danis RP, Davis MD, Ferris FL, Huang SS, Kaiser PK, Kollman C, Sadda S, Scott IU, Qin H (2008) Optical coherence tomography measurements and analysis methods in optical coherence tomography studies of diabetic macular edema. Ophthalmology 115(1366–71):1371Google Scholar
  25. 25.
    Byon IS, Pak GY, Kwon HJ, Kim KH, Park SW, Lee JE (2015) Natural history of idiopathic epiretinal membrane in eyes with good vision assessed by spectral-domain optical coherence tomography. Ophthalmologica 234:91–100CrossRefPubMedGoogle Scholar
  26. 26.
    Guo S, Patel S, Baumrind B, Johnson K, Levinsohn D, Marcus E, Tannen B, Roy M, Bhagat N, Zarbin M (2015) Management of pseudophakic cystoid macular edema. Surv Ophthalmol 60:123–137CrossRefPubMedGoogle Scholar
  27. 27.
    Yonekawa Y, Kim IK (2012) Pseudophakic cystoid macular edema. Curr Opin Ophthalmol 23:26–32CrossRefPubMedGoogle Scholar
  28. 28.
    Chen M, Chen M (2010) Comparison of CDE data in phacoemulsification between an open hospital-based ambulatory surgical center and a free-standing ambulatory surgical center. Clin Ophthalmol 4:1287–1289CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Chen M, Anderson E, Hill G, Chen JJ, Patrianakos T (2015) Comparison of cumulative dissipated energy between the infiniti and centurion phacoemulsification systems. Clin Ophthalmol 9:1367–1372CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Kim SJ, Bressler NM (2009) Optical coherence tomography and cataract surgery. Curr Opin Ophthalmol 20:46–51CrossRefPubMedGoogle Scholar
  31. 31.
    Endophthalmitits Study Group (2007) Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg 33:978–988CrossRefGoogle Scholar
  32. 32.
    Daien V, Papinaud L, Gillies MC, Domerg C, Nagot N, Lacombe S, Daures JP, Carriere I, Villain M (2016) Effectiveness and safety of an intracameral injection of cefuroxime for the prevention of endophthalmitis after cataract surgery with or without perioperative capsular rupture. JAMA Ophthalmol 134:810–816CrossRefPubMedGoogle Scholar
  33. 33.
    Delyfer MN, Rougier MB, Leoni S, Zhang Q, Dalbon F, Colin J, Korobelnik JF (2011) Ocular toxicity after intracameral injection of very high doses of cefuroxime during cataract surgery. J Cataract Refract Surg 37:271–278CrossRefPubMedGoogle Scholar
  34. 34.
    Wong DC, Waxman MD, Herrinton LJ, Shorstein NH (2015) Transient macular edema after intracameral injection of a moderately elevated dose of cefuroxime during phacoemulsification surgery. JAMA Ophthalmol 133:1194–1197CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Schaub F, Adler W, Koenig MC, Enders P, Dietlein TS, Cursiefen C, Heindl LM (2017) Combined ab interno glaucoma surgery does not increase the risk of pseudophakic cystoid macular edema in uncomplicated eyes. J Glaucoma 26:227–232CrossRefPubMedGoogle Scholar
  36. 36.
    Kim SJ, Martin DF, Hubbard GB III, Srivastava SK, Yan J, Bergstrom CS, Aaberg TM Sr (2009) Incidence of postvitrectomy macular edema using optical coherence tomography. Ophthalmology 116:1531–1537CrossRefPubMedGoogle Scholar
  37. 37.
    Banker TP, Reilly GS, Jalaj S, Weichel ED (2015) Epiretinal membrane and cystoid macular edema after retinal detachment repair with small-gauge pars plana vitrectomy. Eur J Ophthalmol 25:565–570CrossRefPubMedGoogle Scholar
  38. 38.
    Sheidow TG, Gonder JR (1998) Cystoid macular edema following combined phacoemulsification and vitrectomy for macular hole. Retina 18:510–514CrossRefPubMedGoogle Scholar

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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