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Factors predictive of cystoid macular edema following endothelial keratoplasty: a single center review of 2233 cases

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First Author: L.Furiosi ITALY

Co Author(s):    J. Myerscough   H. Roberts   A. Yu   M. Mimouni   G. Giannaccare   M. Busin     

Abstract Details

Purpose:

To describe the incidence of postoperative cystoid macular edema (CME) after endothelial keratoplasty (EK) and to identify its contributory risk factors.

Setting:

Tertiary Care Referral Center (Ospedali Privati Forlì, Villa Igea)

Methods:

2233 patients undergoing EK at Ospedali Privati Forlì “Villa Igea”, between January 2005 – October 2018 for DSAEK and June 2014 – August 2018 for DMEK with a minimum follow-up of 18 months were evaluated (a single eye chosen randomly was included in those undergoing EK bilaterally). Univariate and multivariate analyses were conducted to identify and quantify contributory risk factors. Receiver operating characteristic (ROC) curve analysis were performed to determine ideal cut-off points of continuous variables.

Results:

CME was identified in 2.82% (n=63) of the cases. When comparing between DSAEK and DMEK, CME occurred in 2.36% of DSAEK eyes and in 5.56% of DMEK eyes (P=0.001). Average onset of CME was 4.27 months ± 6.63 (range 1-34 months) postoperatively. Compared to those that did not develop CME, patients in the CME group were older (70.5±10.0 vs 67.1±14.3 years, p=0.01), had a higher proportion of diabetic patients (24.2% vs 9.8%, p<0.001) and a higher proportion of patients that underwent DMEK rather than DSAEK (28.6% vs 14.1%, p=0.001). There were no other significant differences between the groups.

Conclusions:

Older age (>67 years), diabetes mellitus, and DMEK have been identified as independent risk factors for postoperative CME following EK. Close observation is necessary during the first postoperative year after EK, particularly in patients with any of the aforementioned risk factors.

Financial Disclosure: