Incidence of clinical and subclinical macular edema in patients submitted to phacoemulsification in a university health service
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Abstract
Introduction: The incidence of cystoid macular edema (CME) after cataract surgery varies substantially and depending on the diagnostic method used. In addition, other factors that influence the incidence of CME are the technique of surgery and the associated comorbidities. Objective: The aim of the present study was to evaluate the incidence of EMC after uncomplicated phacoemulsification surgery, using the spectral domain optical coherence tomography (OCT). Methods: The incidence of sub-clinical and clinical CME was evaluated in 14 patients who underwent uncomplicated phacoemulsification surgery, using OCT before the surgical procedure and after seven and 28 days after it. The volunteers could not use a prostaglandin analogue or present any retinopathy that compromised visual acuity. Results: The incidence of clinically significant CME was 6.4%, however retinal thickening by OCT was observed in all patients in the fourth postoperative week. Regarding gender and laterality, the percentages were similar. Conclusion: In this study, we obtained a low incidence of EMC in patients assisted at this center, corroborating multicenter studies.
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Almeida, L. de, Veiga, G. L. da, Oliveira, F. M. de, Fonseca, F. L. A., Lima, V. L. ., & Abucham Neto, J. Z. . (2020). Incidence of clinical and subclinical macular edema in patients submitted to phacoemulsification in a university health service. ABCS Health Sciences, 45(Suppl.3), e020103. https://doi.org/10.7322/abcshs.2020S03.1850
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14. Diabetic Retinopathy Clinical Research Network Authors/Writing Committee; Baker CW, Almukhtar T, Bressler NM, Glassman AR, Grover S, et al. Macular edema after cataract surgery in eyes without preoperative central-involved diabetic macular edema. JAMA Ophthalmol. 2013;131(7):870-9. https://doi.org/10.1001/jamaophthalmol.2013.2313
15. Arcieri ES, Santana A, Rocha FN, Guapo GL, Costa VP. Blood-aqueous barrier changes after the use of prostaglandin analogues in patients with pseudophakia and aphakia: a 6-month randomized trial. Arch Ophthalmol. 2005;123(2):186-92. https://doi.org/10.1001/archopht.123.2.186
16. Rashid S, Young LH. Progression of diabetic retinopathy and maculopathy after phacoemulsification surgery. Int Ophthalmol Clin. 2010;50(1):155-66. https://doi.org/10.1097/IIO.0b013e3181c555cf
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19. Torron-Fernandez-Blanco C, Ruiz-Moreno O, Ferrer-Novella E, Sánchez-Cano A, Honrubia-Lopez FM. Edema macular quístico pseudofáquico: Detección mediante «optical coherence tomography». Arch Soc Esp Oftalmol. 2006;81(3):147-54.
20. Ching HY, Wong AC, Wong CC, Woo DC, Chan CW. Cystoid macular oedema and changes in retinal thickness after phacoemulsification with optical coherence tomography. Eye (Lond). 2006;20(3):297-303. https://doi.org/10.1038/sj.eye.6701864
21. Lobo CL, Faria PM, Soares MA, Bernardes RC, Cunha-Vaz JG. Macular alterations after small-incision cataract surgery. J Cataract Refract Surg. 2004;30(4):752-60. https://doi.org/10.1016/S0886-3350(03)00582-0
22. Perente I, Utine CA, Ozturker C, Cakir M, Kaya V, Eren H, et al. Evaluation of macular changes after uncomplicated phacoemulsification surgery by optical coherence tomography. Curr Eye Res. 2007;32(3):241-7. https://doi.org/10.1080/02713680601160610
23. Daien V, Korobelnik JF, Delcourt C, Cougnard-Gregoire A, Delyfer MN, Bron AM, et al. French medical-administrative database for Epidemiology and Safety in Ophthalmology (EPISAFE): the EPISAFE collaboration program in cataract surgery. Ophthalmic Res. 2017;58(2):67-73. https://doi.org/10.1159/000456721
24. Shah AS, Chen SH. Cataract surgery and diabetes. Curr Opin Ophthalmol. 2010;21(1):4-9. https://doi.org/10.1097/ICU.0b013e328333e9c1
25. Chen XY, Song WJ, Cai HY, Lin Z. Macular edema after cataract surgery in diabetic eyes evaluated by optical coherence tomography. Int J Ophthalmol. 2016;9(1):81-5. https://doi.org/10.18240/ijo.2016.01.14
26. Kim BY, Smith SD, Kaiser PK. Optical coherence tomographic patterns of diabetic macular edema. Am J Ophthalmol. 2006;142(3):405-12. https://doi.org/10.1016/j.ajo.2006.04.023
27. Biro Z, Balla Z, Kovacs B. Change of foveal and perifoveal thickness measured by OCT after phacoemulsification and IOL implantation. Eye Lond. 2008;22(1):8-12. https://doi.org/10.1038/sj.eye.6702460
2. Ray S, D'Amico DJ. Pseudophakic cystoid macular edema. Semin Ophthalmol. 2002;17(3-4):167-80. https://doi.org/10.1076/soph.17.3.167.14794
3. Belair ML, Kim SJ, Thorne JE, Dunn JP, Kedhar SR, Brown DM, et al. Incidence of cystoid macular edema after cataract surgery in patients with and without uveitis using optical coherence tomography. Am J Ophthalmol. 2009;148(1):128-35.e2. https://doi.org/10.1016/j.ajo.2009.02.029
4. Irvine SR. A newly defined vitreous syndrome following cataract surgery. Am J Ophthalmol. 1953;36(5):599-619. https://doi.org/10.1016/0002-9394(53)90302-x
5. Gass JD, Norton EW. Cystoid macular edema and papilledema following cataract extraction. A fluorescein fundoscopic and angiographic study. Arch Ophthalmol. 1966;76(5):646-61. https://doi.org/10.1001/archopht.1966.03850010648005
6. Henderson BA, Kim JY, Ament CS, Ferrufino-Ponce ZK, Grabowska A, Cremers SL. Clinical pseudophakic cystoid macular edema. Risk factors for development and duration after treatment. J Cataract Refract Surg. 2007;33(9):1550-8. https://doi.org/10.1016/j.jcrs.2007.05.013
7. Mentes J, Erakgun T, Afrashi F, Kerci G. Incidence of cystoid macular edema after uncomplicated phacoemulsification. Ophthalmologica. 2003;217(6):408-12. https://doi.org/10.1159/000073070
8. Kim SJ, Equi R, Bressler NM. Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography. Ophthalmology. 2007;114(5):881-9. https://doi.org/10.1016/j.ophtha.2006.08.053
9. Lally DR, Shah CP. Pseudophakic Cystoid Macular Edema. Pseudophakic CME remains a common cause of reduced vision after cataract surgery. A look at its causes and treatment. Rev Ophthalmol. 2014.
10. Flach AJ. The incidence, pathogensis and treatment of cystoid macular edema following cataract surgery. Trans Am Ophthalmol Soc 1998;96:557-634.
11. Jampol LM. Aphakic cystoid macular edema. A hypothesis. Arch Ophthalmol. 1985;103(8):1134-5. https://doi.org/10.1001/archopht.1985.01050080046017
12. Reese AB, Jones IS, Cooper WC. Macular changes secondary to vitreous traction. Trans Am Ophthalmol Soc. 1966;64:123-34.
13. Yonekawa Y, Kim IK. Pseudophakic cystoid macular edema. Curr Opin Ophthalmol. 2012;23(1):26-32. https://doi.org/10.1097/ICU.0b013e32834cd5f8
14. Diabetic Retinopathy Clinical Research Network Authors/Writing Committee; Baker CW, Almukhtar T, Bressler NM, Glassman AR, Grover S, et al. Macular edema after cataract surgery in eyes without preoperative central-involved diabetic macular edema. JAMA Ophthalmol. 2013;131(7):870-9. https://doi.org/10.1001/jamaophthalmol.2013.2313
15. Arcieri ES, Santana A, Rocha FN, Guapo GL, Costa VP. Blood-aqueous barrier changes after the use of prostaglandin analogues in patients with pseudophakia and aphakia: a 6-month randomized trial. Arch Ophthalmol. 2005;123(2):186-92. https://doi.org/10.1001/archopht.123.2.186
16. Rashid S, Young LH. Progression of diabetic retinopathy and maculopathy after phacoemulsification surgery. Int Ophthalmol Clin. 2010;50(1):155-66. https://doi.org/10.1097/IIO.0b013e3181c555cf
17. Kim SJ, Belair ML, Bressler NM, Dunn JP, Thorne JE, Kedhar SR, et al. A method of reporting macular edema after cataract surgery using optical coherence tomography. Retina. 2008;28(6):870-6. https://doi.org/10.1097/IAE.0b013e318169d04e
18. Corrêa EP, Oliveira LFL, Serracarbassa PD, Oshima A, Castro EFS. Evaluation of macular edema after uncomplicated phacoemulsification surgery with implantation of intraocular lens by spectral domain optical coherencetomography. Arq Bras Oftalmol. 2013;76(6):357-62. https://doi.org/10.1590/S0004-27492013000600008
19. Torron-Fernandez-Blanco C, Ruiz-Moreno O, Ferrer-Novella E, Sánchez-Cano A, Honrubia-Lopez FM. Edema macular quístico pseudofáquico: Detección mediante «optical coherence tomography». Arch Soc Esp Oftalmol. 2006;81(3):147-54.
20. Ching HY, Wong AC, Wong CC, Woo DC, Chan CW. Cystoid macular oedema and changes in retinal thickness after phacoemulsification with optical coherence tomography. Eye (Lond). 2006;20(3):297-303. https://doi.org/10.1038/sj.eye.6701864
21. Lobo CL, Faria PM, Soares MA, Bernardes RC, Cunha-Vaz JG. Macular alterations after small-incision cataract surgery. J Cataract Refract Surg. 2004;30(4):752-60. https://doi.org/10.1016/S0886-3350(03)00582-0
22. Perente I, Utine CA, Ozturker C, Cakir M, Kaya V, Eren H, et al. Evaluation of macular changes after uncomplicated phacoemulsification surgery by optical coherence tomography. Curr Eye Res. 2007;32(3):241-7. https://doi.org/10.1080/02713680601160610
23. Daien V, Korobelnik JF, Delcourt C, Cougnard-Gregoire A, Delyfer MN, Bron AM, et al. French medical-administrative database for Epidemiology and Safety in Ophthalmology (EPISAFE): the EPISAFE collaboration program in cataract surgery. Ophthalmic Res. 2017;58(2):67-73. https://doi.org/10.1159/000456721
24. Shah AS, Chen SH. Cataract surgery and diabetes. Curr Opin Ophthalmol. 2010;21(1):4-9. https://doi.org/10.1097/ICU.0b013e328333e9c1
25. Chen XY, Song WJ, Cai HY, Lin Z. Macular edema after cataract surgery in diabetic eyes evaluated by optical coherence tomography. Int J Ophthalmol. 2016;9(1):81-5. https://doi.org/10.18240/ijo.2016.01.14
26. Kim BY, Smith SD, Kaiser PK. Optical coherence tomographic patterns of diabetic macular edema. Am J Ophthalmol. 2006;142(3):405-12. https://doi.org/10.1016/j.ajo.2006.04.023
27. Biro Z, Balla Z, Kovacs B. Change of foveal and perifoveal thickness measured by OCT after phacoemulsification and IOL implantation. Eye Lond. 2008;22(1):8-12. https://doi.org/10.1038/sj.eye.6702460