Incidence of postvitrectomy macular edema using optical coherence tomography.
OBJECTIVE
To evaluate the incidence, effect on visual recovery, and predisposing risk factors of postvitrectomy macular edema (ME).


METHODS
Prospective cohort study.


METHODS
One-hundred nine eyes undergoing nonemergent vitrectomy surgery.


METHODS
Eyes were evaluated for postoperative day 1 inflammation, 1-month retinal thickness using optical coherence tomography, and preoperative and 1-month postoperative best-corrected visual acuity (BCVA). Macular edema was defined as central subfield thickness > or =272 microm.


METHODS
Retinal thickness, inflammation, and BCVA.


RESULTS
Incidence of ME on optical coherence tomography was 47% (95% confidence interval [CI], 37%-56%). Mean 1-month visual acuity improved 3.3 lines (0.33 logarithm of minimum angle of resolution [logMAR] units) to 20/80(+1) (0.58+/-0.46 logMAR units) from 20/150(-2) (0.91+/-0.63 logMAR units) before surgery (P<0.001). Mean 1-month center point thickness (CPT), central subfield (CSF), and total macular volume were 265+/-107 microm, 288+/-94 microm, and 7.8+/-1.2 mm(3), respectively. Severity of postoperative inflammation predicted retinal thickness at 1 month (P<0.05). Intraoperative epinephrine use was associated with increased postoperative inflammation (P = 0.02). Eyes with greater reduction in CSF (or CPT) from baseline experienced more rapid visual recovery (r = -0.36; 95% CI, -0.61 to -0.06; P = 0.02).


CONCLUSIONS
Postvitrectomy ME is common and delays visual recovery. Degree of postoperative inflammation is an important risk factor for ME and, in this series, was increased in the setting of intraocular epinephrine. Efforts to reduce or prevent inflammation after vitrectomy should be beneficial and therefore are encouraged.
Kim
Stephen J
SJ
Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. skim30@gmail.com
Martin
Daniel F
DF
Hubbard
G Baker
GB
Srivastava
Sunil K
SK
Yan
Jiong
J
Bergstrom
Chris S
CS
Aaberg
Thomas M
TM
D005260:Female; D006801:Humans; D015994:Incidence; D008269:Macular Edema / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D012160:Retina / Q000473:pathology; D012164:Retinal Diseases / Q000601:surgery; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000601:surgery