Preexisting epiretinal membrane is associated with pseudophakic cystoid macular edema

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 256; no. 5; pp. 909 - 917
• Main Authors: Schaub, Friederike, Adler, Werner, Enders, Philip, Koenig, Meike C., Koch, Konrad R., Cursiefen, Claus, Kirchhof, Bernd, Heindl, Ludwig M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2018; Springer Nature B.V
• Subjects: Cataracts; Diabetes mellitus; Diabetic retinopathy; Edema; Endophthalmitis; Eye; Eye lens; Eye surgery; Inflammation; Macular degeneration; Medicine; Medicine & Public Health; Ophthalmology; Retina; Retinal Disorders; Retinopathy; Surgery; Trauma; Uveitis; Complication; Cataract; Phacoemulsification; Epiretinal membrane; Cystoid macular edema
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-018-3954-4

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.