Rate of Cystoid Macular Edema after Uncomplicated Phacoemulsification Surgery Using Optical Coherence Tomography

Abstract

CME is a common cause of decreased VA after cataract surgery. It results from disruption of the BRB and subsequent accumulation of fluid leading to increased thickness of retina. OCT is commonly used in diagnosis of CME. It allows morphologic and quantitative assessment of macular edema by producing 2-D or 3-D images of the retinal tissue and monitoring efficacy of the treatment done. 20 cases of IMSC have been included in this study, they have been subjected to taking full detailed history, detailed ophthalmological examination, uncomplicated phaco procedure and postoperative follow up in form of complete clinical ophthalmological examination and OCT was done week-1 and week-4 after surgery.  2 cases (10%) came complaining of painless diminution of vision after initial improvement with surgery and metamorphopsia. On fundus biomicroscopy, the cases showed loss of the normal foveal reflex with cystic changes and spoke-like radial striae in fovea.  In week-4 postoperative follow up, OCT shows cystic changes in the macula with increase macular thickness and volume in two cases who were male and diabetic patients.  Cases with CME showed reduction in postoperative BCVA.  Cases with CME continued treatment on steroid and NSAIDs eye drops for further three months after detection of CME.  On further follow up patients who developed CME three months later by OCT there is significant reduction in CFT, parafoveal and perifoveal subfields and return near to week-1 postoperative values that were more increased significantly in this cases at week-4 postoperative.  BCVA improved on the follow up done one month after surgery, and after four months for cases who developed clinically significant CME.  Significant positive correlation was found between CFT and BCVA (P value<0.001).