Risk of Pseudophakic Cystoid Macular Edema in Fellow-Eye Cataract Surgeries
Ophthalmology Volume 130, Number 6, June 2023
本研究旨在確定對側眼白內障手術的pseudophakic cystoid macular edema （pCME）風險，並識別潛在的風險因素，包括先前的第一眼pCME。該研究納入在英國8家國家衛生服務中心進行雙眼非同期白內障手術的患者。排除具有糖尿病性黃斑水腫（DME）、CME 或preoperative or perioperative use of NSAID的患者。計算了pCME的總體風險，並使用Poisson模型識別了對側眼pCME的風險因素。研究發現，對側眼白內障手術的pCME風險約為1%。先前的第一眼pCME的存在是最強獨立的風險因素，使風險增加了8倍以上。該研究強調了對患者進行有關對側眼白內障手術中pCME的潛在風險的諮詢的重要性，特別是如果他們有第一眼pCME的病史。
This study aimed to determine the risk of pseudophakic cystoid macular edema (pCME) in fellow-eye cataract surgery and identify potential risk factors, including prior first-eye pCME. The study included patients undergoing bilateral nonsimultaneous cataract surgeries in 8 UK National Health Service centers. Patients with a history of diabetic macular edema (DME), cystoid macular edema (CME), or perioperative nonsteroidal anti-inflammatory drug (NSAID) use were excluded. The overall risk of pCME was calculated, and a Poisson model was used to identify risk factors for pCME in the fellow eye. The study found that the risk of pCME in fellow-eye cataract surgery was approximately 1%. The presence of prior first-eye pCME was the strongest independent risk factor, increasing the risk more than eightfold. The study highlights the importance of counseling patients about the potential risk of pCME in fellow-eye cataract surgeries, particularly if they have a history of pCME in the first eye.
The risk of fellow-eye pCME among patients without first-eye pCME was 0.9%. However, the risk of fellow-eye pCME among those with first-eye pCME was 10.7%. In the fully adjusted model, we found that the risk factors for the development of fellow-eye pCME were first-eye
pCME (RR, 8.55, 95% confidence interval [CI], 6.19-11.8), epiretinal membrane (ERM) (RR, 4.1, CI,
2.63-6.19), history of retinal vein occlusion (RR, 2.94, CI, 1.75-4.93), diabetes without history of DME (RR, 2.08,CI, 1.73-2.5), advanced cataract (RR, 1.75, CI, 1.16-2.65), prostaglandin analogue use preoperatively (RR, 1.49,CI, 1.13-1.97), and male sex (RR, 1.19, CI, 1.0-1.41)