INCREASED RISK OF CYSTOID MACULAR EDEMA AFTER CATARACT SURGERY IN EYES PREVIOUSLY VITRECTOMIZED FOR IDIOPATHIC EPIRETINAL MEMBRANE

Purpose: To assess the rate and risk factors of cystoid macular edema (CME) both after isolated vitrectomy and after subsequent phacoemulsification in eyes with primary noncomplicated rhegmatogenous retinal detachment (RRD) or idiopathic epiretinal membrane (ERM). Methods: Retrospective observation of institutional patients undergoing vitrectomy for RRD or vitrectomy with internal limiting membrane peeling for ERM from 2016 to 2021, further analyzing those who later underwent phacoemulsification. The CME rate was assessed within the first 6 months after both vitrectomy and cataract surgery. Results: The authors included 187 phakic eyes with ERM and 311 with RRD undergoing isolated vitrectomy. Postvitrectomy CME occurred in 12.8% of ERM cases compared with 1% in RRD cases (P < 0.0001). Stage-4 ERMs and intraoperative laser were found associated with CME. After uncomplicated phacoemulsification, the CME rate was higher in eyes vitrectomized for ERM (13.8%) compared with RRD (2%, P = 0.0055). Postvitrectomy CME was found to be associated with an increased risk of postcataract CME (odds ratio 13.588, P = 0.0187). Conclusion: In eyes undergoing phacoemulsification postvitrectomy, the risk of CME is higher when vitrectomy was performed for ERM compared with RRD. The ERM-related intraretinal changes, together with the required surgical stress, may play a role in making these eyes more susceptible to CME.