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A Scottish ophthalmological surveillance unit study of persistent cystoid macular oedema following uncomplicated cataract surgery

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First Author: O.Erikitola UK

Co Author(s):    T. Siempis   B. Foot   D. Lockington              

Abstract Details

Purpose:

Post-operative cystoid macular oedema (CMO) can cause deterioration of vision following routine cataract surgery. The incidence of persistent CMO (pCMO; defined as CMO present after 3 months) following uncomplicated surgery is uncertain. We wished to identify the incidence, management and visual outcomes of such patients.

Setting:

All ophthalmic centres throughout Scotland.

Methods:

A Scottish Ophthalmology Surveillance Unit (SOSU) questionnaire was sent monthly to every ophthalmic specialist in Scotland over an 18-month period from 1st January 2018 asking them to report all new patients with pCMO confirmed on OCT scanning following uncomplicated cataract surgery. A follow-up questionnaire was sent 9 months after initial presentation.

Results:

Fourteen cases of pCMO were reported, giving an incidence of 2.2 cases of pCMO per 10,000 uncomplicated cataract surgeries. Mean age was 74.9 +/- 10.2 years with a male preponderance (72.7%). Six patients had hypertension and 1 had diabetes. Three eyes required intracameral adjuncts (2 iris hooks, 1 intracameral phenylephrine). Postoperative visual acuity (VA) at 3 months was logMAR 0.48 (0.2-0.8). Average mean central retinal thickness (CRT) at 3 months was 497microns (270-788). The most common initial treatment comprised topical steroids and topical NSAIDs (61.5%).At 1-year post-op, mean VA was logMAR 0.18 (0.1-0.3) with average mean CRT of 327microns (245-488).

Conclusions:

We identified a low incidence of pCMO following uncomplicated cataract surgery in Scotland (0.02%), with inconsistent and variable management regimes. A nationally agreed treatment protocol is required.

Financial Disclosure:

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