Incidence of postoperative cystoid macular edema following vitreoretinal surgery for primary rhegmatogenous retinal detachment.

摘要

Purpose : To evaluate the incidence of postoperative cystoid macular edema (CME) in patients undergoing episcleral and/or pars plana vitrectomy for primary rhegmatogenous retinal detachment (RRD). Methods : In a retrospective study,28 eyes of 28 patients who were treated for primary RRD were evaluated. Depending on the surgical technique, patients were divided into 3 groups: SB Group, PPV Group and SB+PPV Group.Postoperative optical coherence tomography (OCT) was performed to assess the status of the macula. Functional outcomes and data concerning the surgical techniques were also recorded. Results : SB, PPV and SB+PPV Group included 9, 3 and 16 patients, respectively. The retina was reattached in 26 out of 28 cases (92.8%). Best corrected visual acuity (BCVA) improved in all the 3 groups. In the SB+PPV Group, all phakic patients (4/16) underwent simultaneous cataract extraction and gas tamponade (C3F8 12% or SF6 20%) was applied in 7 patients, while SO was preferred in 9 cases. OCT revealed postoperative CME in 10 out of 28 patients (39,3%) who had been treated with SB alone or combined to PPV. Cryopexy had been applied in 6 of them (60%). Once analyzed separately, macular edema was detected in 44.4% and 37.5% of patients within the SB Group and SB+PPV Group, respectively. No macular edema was observed in the PPV Group. There was no difference on the incidence of CME in patient undergoing SO or gas tamponade (40% vs 41.7%, respectively). Neither the duration of surgery nor the contemporary cataract extraction were statistically correlated with the development of postoperative CME. No significant difference were found between eyes with and without postoperative CME with regard to final visual. Conclusions : Although never reported in literature, postoperative CME may develop in case of primary RRD successfully treated with SB alone or in association to PPV. However, this does not seem to correlate with both the duration of surgery and the type of intraocular tamponade. Combined anterior and posterior segment surgery is not associated with a higher risk of CME, and cryopexy appears to be the only risk factor. Furthermore, functional outcomes do not seem to be influenced by the presence of postoperative CME. This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.