Diabetes Patients with RVO and Prior CME at higher risk of Macular Edema After Cataract Surgery: Study
A recent study published in the Indian Journal of Ophthalmology has identified significant risk factors for postoperative macular edema (PME) following cataract surgery in patients with retinal vein occlusion (RVO).
The study found that patients with a history of cystoid macular edema (CME) requiring intravitreal treatment and those with diabetes are at a notably higher risk of developing PME after uneventful cataract surgery.
The retrospective study analyzed 162 eyes from 162 RVO patients who underwent cataract surgery between January 2015 and December 2019. Patients were followed for an average of 13 months post-surgery. The results indicated that PME developed within three months postoperatively in 40.1% of all eyes. Specifically, PME occurred in 21% of eyes without prior CME, 57.3% of eyes with prior CME, and 50% of eyes in diabetic patients.
Multivariate analysis revealed that diabetes increased the odds of developing PME by 2.1 times, while a history of CME requiring treatment raised the risk by 4.62 times. Additionally, prior anti-VEGF therapy was associated with a 4.83-fold increased risk. Although visual acuity improved significantly post-surgery-from 0.85 ± 0.55 logMAR at baseline to 0.365 ± 0.39 logMAR at final follow-up-eyes that developed PME had a higher likelihood of poorer visual outcomes, with many not achieving better than 6/18 vision.
These findings underscore the importance of preoperative risk assessment in RVO patients, particularly those with a history of CME or diabetes. The study recommends routine optical coherence tomography (OCT) scans during the first postoperative visit to detect early PME, enabling timely intervention to preserve visual acuity.
