Development of cystoid macular edema after uneventful cataract surgery in eyes with a history of vitrectomy using silicone oil versus gas tamponade

Eye (Lond). 2024 May;38(7):1327-1332. doi: 10.1038/s41433-023-02898-x. Epub 2023 Dec 27.

Abstract

Background/objectives: The purpose of this study is to investigate whether history of silicone oil tamponade may predispose to the development of cystoid macular edema (CMO) following uneventful post-vitrectomy cataract surgery.

Subjects/methods: This is a retrospective study that was conducted at a single academic institution. Records of patients who underwent pars plana vitrectomy (PPV) with or without silicone oil tamponade and subsequent cataract surgery between 2017-2020 were reviewed. Macular optical coherence tomography (OCT) findings up to 4 years after surgery were assessed.

Results: A total of 95 eyes were included. Forty-one eyes underwent cataract surgery and had a history of PPV with silicone oil tamponade (Group 1). Fifty-four eyes underwent cataract surgery by phacoemulsification and had a history of PPV with gas tamponade (Group 2). Average follow up time after cataract surgery was 41.1 months. In Group 1, the incidence of OCT-detected CMO was 39.0%, compared to 27.8% in Group 2 (p = 0.247). The incidence of clinically significant CMO in Group 1 was 22.0%, compared to 18.5% in Group 2 (p = 0.679). The duration of CMO was significantly longer in Group 1 (p = 0.041) and cases were less likely to resolve by the last follow up visit (p = 0.040).

Conclusions: The incidence of OCT-detected or clinically significant pseudophakic CMO is not significantly different between eyes with prior PPV with gas tamponade versus silicone oil tamponade. However, CMO after uneventful cataract surgery may have a prolonged course if there is history of silicone oil tamponade, requiring longer treatment.

MeSH terms

  • Aged
  • Cataract Extraction / adverse effects
  • Endotamponade*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Macular Edema* / etiology
  • Male
  • Middle Aged
  • Phacoemulsification / adverse effects
  • Postoperative Complications
  • Retrospective Studies
  • Silicone Oils* / administration & dosage
  • Silicone Oils* / adverse effects
  • Tomography, Optical Coherence*
  • Visual Acuity*
  • Vitrectomy* / adverse effects

Substances

  • Silicone Oils