From the Vanderbilt Eye Institute (S.G., S.G.), Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Center for Clinical Epidemiology and Biostatistics (C.N.), Department of Biostatistics and Epidemiology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Am J Ophthalmol. 2024 Nov;267:182-191. doi: 10.1016/j.ajo.2024.06.006. Epub 2024 Jun 15.
To evaluate the incidence, remission, and relapse of post-surgical cystoid macular edema (PCME) following cataract surgery in inflammatory eye disease.
A total of 1859 eyes that had no visually significant macular edema prior to cataract surgery while under tertiary uveitis management were included. Standardized retrospective chart review was used to gather clinical data. Univariable and multivariable logistic regression models with adjustment for inter-eye correlations were performed.
PCME causing VA 20/50 or worse was reported in 286 eyes (15%) within 6 months of surgery. Adults age 18-64 years as compared to children (adjusted odds ratio [aOR] = 2.42, for ages 18 to 44 years and aOR = 1.93 for ages 45 to 64 years, overall P = .02); concurrent use of systemic immunosuppression (conventional aOR 1.53 and biologics aOR = 2.68, overall P = .0095); preoperative VA 20/50 or worse (overall P < .0001); cataract surgery performed before 2000 (overall P = .03) and PMCE in fellow eye (aOR = 3.04, P = .0004) were associated with development of PCME within 6 months of cataract surgery. PCME resolution was seen in 81% of eyes at 12 months and 91% of eyes at 24 months. CME relapse was seen in 12% eyes at 12 months and 19% eyes at 24 months.
PCME occurs frequently in uveitic eyes undergoing cataract surgery; however, most resolve within a year. CME recurrences likely are due to the underlying disease process and not relapses of PCME.
评估炎症性眼病患者白内障手术后黄斑囊样水肿（PCME）的发生率、缓解率和复发率。
共纳入 1859 只在接受三级葡萄膜炎管理的情况下，白内障手术前无明显黄斑水肿的眼。采用标准化回顾性图表审查收集临床数据。采用单变量和多变量逻辑回归模型，并进行眼间相关性调整。
术后 6 个月内，286 只眼（15%）出现导致 VA 20/50 或更差的 PCME。与儿童相比，18-64 岁的成年人（调整后的优势比[OR]为 2.42，年龄为 18-44 岁，调整后的 OR 为 1.93，年龄为 45-64 岁，总 P =.02）；同时使用全身免疫抑制（常规 aOR 为 1.53，生物制剂 aOR 为 2.68，总 P =.0095）；术前 VA 20/50 或更差（总 P <.0001）；2000 年以前进行白内障手术（总 P =.03）和对侧眼 PMCE（OR = 3.04，P =.0004）与白内障手术后 6 个月内 PCME 的发生相关。PCME 在 12 个月时有 81%的眼得到缓解，在 24 个月时有 91%的眼得到缓解。在 12 个月时有 12%的眼出现 CME 复发，在 24 个月时有 19%的眼出现 CME 复发。
PCME 在接受白内障手术的葡萄膜炎眼中常发生；然而，大多数在一年内缓解。CME 复发可能是由于潜在的疾病过程，而不是 PCME 的复发。
