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Saturday, August 26, 2006

Cystoid macular edema after pars plana vitrectomy for retained lens fragments.

Cystoid macular edema after pars plana vitrectomy for retained lens fragments.

J Cataract Refract Surg. 2006 Sep;32(9):1521-1526.

From the Department of Ophthalmology (Cohen), University of South Florida, Tampa, and Warrington College of Business (Davis), University of Florida, Gainesville, Florida, and the Department of Ophthalmology (Cukrowski), Michigan State University, East Lansing, Michigan, USA.

PURPOSE: To describe the incidence and clinical course in patients with cystoid macular edema (CME) following pars plana vitrectomy (PPV) for retained lens fragments.

SETTING: Retina group, private practice.

METHODS: This retrospective study reviewed the medical records of 91 patients who had PPV for retained lens fragments. The patients were followed for at least 6 months. Patients with concomitant eye diseases that adversely affected macular examination or macular function were excluded.

RESULTS: Four (8%) of 50 eyes with a sulcus-fixated posterior chamber intraocular lens (PC IOL) implanted at cataract extraction and 19 (46%) of 41 eyes with aphakia or an anterior chamber IOL developed CME

The CME developed a mean of 4 months after PPV. Treatment consisted of steroid eyedrops in all eyes; 17 eyes were also treated with a topical cyclooxygenase inhibitor, and 5 eyes received posterior sub-Tenon's steroid injections. The CME resolved a mean of 2 months after 1 treatment course in 12 eyes, which had a final visual acuity of 20/40 or better. The CME resolved, recurred, and then resolved in 6 eyes. In these eyes, the first incidence lasted a mean of 4 months. The second episode occurred a mean of 5 months after the initial episode resolved and took a mean of 3 months to resolve. Final visual acuity was 20/40 or better in 5 of these eyes. The CME persisted in 5 eyes that were followed for a mean of 30 months. None of these eyes had an acuity of 20/40 or better.

CONCLUSIONS: Sulcus placement of a PC IOL at cataract extraction was associated with a reduced risk for CME. The prognosis for eyes that develop CME after PPV for retained lens fragments is guarded. Long-term therapy should be considered because of the high rate of recurrence.

PMID: 16931266 [PubMed - as supplied by publisher]

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