Du Jeanette, Landa Gennady
From the Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York (Du, Landa); Icahn School of Medicine at Mount Sinai, New York, New York (Landa).
J Cataract Refract Surg. 2023 Mar 1;49(3):266-271. doi: 10.1097/j.jcrs.0000000000001097.
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).
New York Eye and Ear Infirmary of Mount Sinai, New York, New York.
Retrospective cohort study.
Records of 365 subjects who 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.
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.
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.
研究既往因孔源性视网膜脱离（RRD）行玻璃体切除术（PPV）是否易导致人工晶状体眼黄斑囊样水肿（CME）的发生。
纽约西奈山眼耳医院，纽约，纽约。
回顾性队列研究。
回顾2017年至2020年间365例行PPV治疗RRD并随后接受白内障手术患者的记录。排除有糖尿病视网膜病变、炎性视网膜血管疾病、葡萄膜炎、晚期年龄相关性黄斑变性、眼内感染、近视性黄斑病变或术中出现严重并发症而无法植入后房型人工晶状体的患者。年龄匹配的接受常规白内障手术的患者作为对照组。获取术后4年内的临床数据和黄斑光学相干断层扫描（OCT）结果。
54只眼通过超声乳化术顺利完成白内障手术，且有PPV联合气体填充史。55只眼仅顺利完成白内障手术。白内障手术后的平均随访时间为39.1个月。有PPV史的眼中，OCT检测到的CME发生率为27.8%（15/54），而对照组为3.8%（2/55）（P <.001）；具有临床意义的CME发生率为18.5%（10/54），对照组为1.8%（1/55）（P =.004）。80%（12/15）的CME病例接受了局部治疗，无一例需要玻璃体腔内注射。
既往因RRD行PPV与白内障手术后人工晶状体眼CME发生率增加相关。对于这些患者，考虑预防性或延长术后抗炎局部治疗可能是谨慎的做法。
