Impact of prior pars plana vitrectomy on development of cystoid macular edema after uneventful cataract surgery

Purpose: To investigate whether a history of prior pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) predisposes to the development of pseudophakic cystoid macular edema (CME). Setting: New York Eye and Ear Infirmary of Mount Sinai, New York, New York. Design: Retrospective cohort study. Methods: Records of 365 subjectswho underwent PPV for RRD and subsequent cataract surgery between 2017 and 2020 were reviewed. Patients with a history of diabetic retinopathy, inflammatory retinal vascular disease, uveitis, advanced age-related macular degeneration, intraocular infection, myopic maculopathy, or significant intraoperative complications precluding posterior chamber intraocular lens placement were excluded. Age-matched subjects who underwent routine cataract surgery served as controls. Clinical data and macular optical coherence tomography (OCT) findings up to 4 years postoperatively were obtained. Results: 54 eyes underwent uneventful cataract surgery by phacoemulsification and had a history of PPV with gas tamponade. 55 eyes underwent uneventful cataract surgery only. The average follow-up time after cataract surgery was 39.1 months. In eyes with a history of PPV, the incidence of OCT-detected CME was 27.8% (15/54) compared with 3.8% (2/ 55) in the control group (P <.001) and the incidence of clinically significant CME was 18.5% (10/54) compared with 1.8% (1/ 55) in the control group (P=.004). 80% (12/15) of CME cases were treated with topical therapy, and none required intravitreal injection. Conclusions: Prior PPV for RRD is associated with an increased incidence of pseudophakic CME after uneventful cataract surgery. Prophylactic or prolonged postoperative anti-inflammatory topical therapy may be prudent to consider in these patients. Copyright (c) 2022 Published by Wolters Kluwer on behalf of ASCRS and ESCRS