Incidence, Clinical Features and Risk Factors for Cystoid Macular Edema after Cataract Surgery

Abstract

Background: Pseudophakic cystoid macular oedema (PCME) is an important postoperative finding after cataract surgery and may affect visual recovery. Aim: To assess the incidence, clinical characteristics, and risk factors of pseudophakic cystoid macular edema (PCME) in patients undergoing cataract surgery at a medical college hospital over a period of seventeen months. Study design: Prospective observational study. Place and Duration of Study: Department of Ophthalmology, Malla Reddy Medical College for Women, Hyderabad, Telangana, India, from September 2022 to January 2024. Methodology: A total of 510 patients who underwent uncomplicated cataract surgery were included in the study. Demographic data, comorbidities, central subfield thickness (CST), visual acuity, and intraocular pressure (IOP) were collected preoperatively and at 2 and 4 weeks postoperatively. Results: Statistical analysis was performed using SPSS version 26. Nineteen patients (3.7%) of those evaluated at four weeks had cystoid macular edema, confirmed by optical coherence tomography (OCT). Among the 19 CME cases, 8 (42.1%) occurred in patients aged 60–69 years. CME was more frequent among males (68.4%) than females (31.6%). However, CME was not significantly associated with the presence of risk factors such as DM, hypertension (HTN), or coronary artery disease (CAD) (p = 0.803; p > 0.05). Post-cataract surgery findings, including IOL placement in the sulcus (p = 0.002), pigment dispersion on the IOL (p = 0.006), PC opacification (p = 0.010), and a dull foveal reflex (p < 0.001), were associated with CME. Age was not significantly associated with CME (p = 0.823). CME occurred in 14 of 313 patients (4.5%) after SICS and in 5 of 197 patients (2.5%) after phacoemulsification; based on the reported counts, this difference was not statistically significant (Pearson chi-square p = 0.261). Conclusion: PCME occurred in 3.7% of patients at four weeks; age and the combined DM/HTN/CAD risk-factor category were not significantly associated with CME.