There are limited studies examining the incidence and risk factors for postoperative cystoid macular oedema (CMO) following rhegmatogenous retinal detachment (RRD) repair. Postoperative CMO is thought to be due to pro-inflammatory state, where numerous cytokines lead to tight junction dysfunction, permeability and thus CMO. A total of 2729 eyes that underwent primary RRD repair (scleral buckle (SB), pars plana vitrectomy (PPV) or a combination (SB/PPV)) were included in this analysis. Overall, nearly 10% of eyes developed CMO postoperatively. Older age (Odds ratio (OD), 1.03 per year), history of glaucoma (OR 2.02), topical glaucoma drops (OR 2.23), preoperative proliferative vitreo-retinopathy (PVR) (OR 2.1), intraoperative triamcinolone (OR 1.71), perfluorocarbon liquid use (OR 1.64) and postoperative cataract surgery following RRD repair (OR 2.54) were associated with higher risk of postoperative CMO. PPV and PPV/SB had a higher risk of CMO than SB. Single surgery success (OR 0.42 in phakic and 0.22 in pseudophakic eyes) was protective. The authors conclude that cataract removal and retinal re-detachment following RRD repair are the biggest predictors for the development of postoperative CMO. In pseudophakic eyes, older age was the most important risk factor.
Cystoid macular oedema following retinal detachment surgery
Reviewed by Kurt Spiteri Cornish
Risk factors for presence of cystoid macular edema following rhegmatogenous retinal detachment surgery.
CONTRIBUTOR
Kurt Spiteri Cornish
Sheffield Teaching Hospitals NHS Trust, London, UK.
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