Evaluating rates of cystoid macular edema after dropless cataract surgery

Session Details

Session Title: Cataract Surgery: Complications & Management

Session Date/Time: Tuesday 17/09/2019 | 14:00-16:00

Paper Time: 14:38

Venue: Free Paper Forum: Podium 1

First Author: : P.Shah USA

Co Author(s): :    M. Macsai   M. Shiloach                          

Abstract Details

Purpose:

Advantages of dropless cataract surgery include a simplified regimen, convenience, and compliance for patients. However, limited data exist on the outcomes of this technique. The purpose of this study is to compare the frequency of CME in non-high risk patients after cataract surgery with new perioperative medication methods.

Setting:

NorthShore University HealthSystem, Glenview, IL, USA

Methods:

Our electronic data warehouse was retrospectively queried to identify a single surgeon’s cataract surgery cases and classify into three groups of patients: Group 1 was given topical steroids, nonsteroidal, and antibiotic drops. Group 2 received subconjunctival injection of 0.1mL Kenalog (40mg/mL), and intracameral and transzonular injections of 0.3mL moxifloxacin (0.1mg/0.1mL), which was also used to hydrate the paracentesis. Group 3 was administered moxiflaxacin as in group 2 and given topical steroids. CME cases were found by diagnosis code assigned after surgery, excluding patients with pre-existing macular edema, epiretinal membrane, diabetic retinopathy, or retinal detachment history.

Results:

A total of 961 cataract procedures were identified from June 2012 to December 2017. In groups 1, 2, and 3, there were 194, 566 and 201 cases, respectively. The rate of CME in Group 1 using conventional drops was 0.52%. In group 2, using the dropless medication method, the CME rate was 1.77%. In group 3 (steroid drops only) the rate of CME was 1.49%. There was no statistical significance (p>0.05) using chi-square test between the groups.

Conclusions:

The CME rate was mildly increased in our patients when a dropless technique was used, although this rate was still low. Intracameral moxifloxacin and subconjunctival kenalog should be considered in all non-high risk patients, but especially in those having difficulty instilling or complying with eye drops, or where medication is cost-prohibitive.

Financial Disclosure:

None