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Use of pupil expansion devices and risk of pseudophakic cystoid macular oedema

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First Author: A.Silvester UK

Co Author(s):    J. Karthikappallil   A. Oberholster   A. Zafar              

Abstract Details

Purpose:

The aim of this study was to determine the incidence of cystoid macular oedema following the use of a pupil expansion device during cataract surgery.

Setting:

17 eye hospitals in the UK from 01/01/12 to 31/12/19.

Methods:

Retrospective analysis of electronic medical records of 99,465 cataract operations. All patients had routine cataract surgery and were reviewed at 4 weeks post cataract surgery.

Results:

99,465 operations performed at 17 sites in the UK, overall incidence of cystoid macular oedema (CMO) was 2.91%. Incidence of CMO in patients in which a pupil expander was used was 4.74%, Odds ratio 1.72 (CI 1.45 to 2.05) p value 0.0001. Incidence was highest (7.0%) in patients under 60 years requiring a pupil expander, particularly if they were also diabetic OR 1.54 (1.2 to 2.1, p value 0.01.

Conclusions:

The use of a pupil expanding device during cataract surgery significantly increases the risk of developing post operative cystoid macular oedema. This risk is greatest in diabetic patients under 60 years of age. When a pupil expansion device is used during cataract surgery, patients should be informed about the increased risk of a complication and post operative prophylaxis should be considered.

Financial Disclosure:

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