Researchers from Germany have identified open-angle glaucoma as an independent risk factor for pseudophakic cystoid macular edema (CME). They also found that intraoperative trauma, as well as impairment of the blood-retinal barrier pre- or post-cataract surgery, promotes pseudophakic CME. The team presented their findings last week in Vancouver at ARVO 2019.

The study analyzed 1,000 eyes of 738 patients that received cataract surgery. Of these, 32 eyes of 30 patients developed pseudophakic CME. Patients with pseudophakic CME had increased incidence of diabetic retinopathy (DR) of preoperative epiretinal membranes and increased incidence of OAG. None of the pseudophakic CME patients with glaucoma had received any previous glaucoma surgery. The study also found a tendency to posterior capsule rupture and postoperative sterile inflammation in patients.

Researchers found no increased frequency of prostaglandin analogs in pseudophakic CME cases. Pre- or post-op impairment of the blood-retinal barrier is also seen in DR and sterile inflammation, and the researchers have noted that preoperative therapy with non-steroidal anti-inflammatory drugs (NSAIDs) can be beneficial for DR patients. Therefore, they believe that preoperative prophylactic treatment of OAG patients with NSAIDs seems worthwhile.

Hoerster R, von Netzer C, Schulze, et al. Glaucoma as a risk factor for early pseudophakic macular edema – an analysis of 1000 cataract surgeries. ARVO 2019. Abstract 499.