Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, Scotland, UK.
Royal College of Ophthalmologists, London, UK.
Eye (Lond). 2021 Feb;35(2):584-591. doi: 10.1038/s41433-020-0908-y. Epub 2020 May 6.
Post-operative cystoid macular oedema (CMO) can cause deterioration of vision following routine cataract surgery. The incidence of persistent CMO (pCMO; defined as CMO present after 3 months) following uncomplicated surgery is uncertain. We wished to identify the incidence, management and visual outcomes of such patients.
A Scottish Ophthalmological Surveillance Unit (SOSU) questionnaire was sent monthly to every ophthalmic specialist in Scotland over an 18-month period from 1st January 2018 asking them to report all new patients with pCMO confirmed on OCT scanning following uncomplicated cataract surgery. A follow-up questionnaire was sent 9 months after initial presentation.
Fourteen cases of pCMO were reported, giving an incidence of 2.2 cases of pCMO per 10,000 uncomplicated cataract surgeries. Mean age was 74.9 years (SD 10.2; range 44-86) with a male preponderance (72.7%). Two patients developed pCMO in each eye. Six cases (46.2%) had hypertension and one had diabetes. Three eyes required intracameral adjuncts (two iris hooks, one intracameral phenylephrine). Postoperative visual acuity (VA) at 3 months was logMAR 0.48 (0.2-0.8). Average mean central retinal thickness (CRT) at 3 months was 497microns (270-788). The most common initial treatment comprised topical steroids and topical NSAIDs (61.5%). Other management strategies included systemic steroids, intravitreal steroids and oral acetazolamide. At 1-year post-op, mean VA was logMAR 0.18 (0.1-0.3) with average mean CRT of 327microns (245-488).
We identified a low incidence of pCMO following uncomplicated cataract surgery in Scotland (0.02%), with inconsistent and variable management regimes. A nationally agreed treatment protocol is required.
术后囊样黄斑水肿（CME）可导致常规白内障手术后视力恶化。在无并发症手术后持续性 CME（pCME；定义为手术后 3 个月存在 CME）的发生率尚不确定。我们希望确定此类患者的发生率、治疗方法和视力结果。
在 2018 年 1 月 1 日至 2019 年 6 月期间，苏格兰眼科监测单位（SOSU）每月向苏格兰的每位眼科专家发送一份调查问卷，要求他们报告所有在接受无并发症白内障手术后 OCT 扫描证实为 pCME 的新患者。在初次就诊后 9 个月发送了一份随访问卷。
报告了 14 例 pCME，每 10000 例无并发症白内障手术中 pCME 的发生率为 2.2 例。平均年龄为 74.9 岁（标准差 10.2；范围 44-86），男性居多（72.7%）。两名患者每只眼均发生 pCME。6 例（46.2%）患者患有高血压，1 例患者患有糖尿病。3 只眼需要使用眼内辅助物（2 只虹膜钩，1 只眼内苯肾上腺素）。术后 3 个月时的视力（VA）为 logMAR 0.48（0.2-0.8）。3 个月时平均中央视网膜厚度（CRT）为 497μm（270-788）。最初最常见的治疗方法包括局部皮质类固醇和局部非甾体抗炎药（61.5%）。其他治疗策略包括全身皮质类固醇、眼内皮质类固醇和口服乙酰唑胺。术后 1 年时，平均 VA 为 logMAR 0.18（0.1-0.3），平均 CRT 为 327μm（245-488）。
我们发现苏格兰无并发症白内障手术后 pCME 的发生率较低（0.02%），治疗方案不一致且各不相同。需要制定全国统一的治疗方案。
