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Cystoid macular edema after Descemet's stripping endothelial keratoplasty

Poster Details

First Author: I.Van der Meulen THE NETHERLANDS

Co Author(s):    M. Alder   C. Nieuwendaal   R. Lapid-Gortzak        

Abstract Details



Purpose:

: 1) To determine the prevalence of cystoid macular edema (CME) after Descemet's stripping endothelial keratoplasty (DSEK), 2) to identify risk-factors as well as the postoperative time-interval for the development of the edema and 3) to compare visual outcomes between groups with and without postoperative cystoid macular edema.

Setting:

A tertiary referral center: Academic Medical Center, Amsterdam, the Netherlands

Methods:

Retrospective case series. All patients who underwent DSEK between November 2005 and July 2013 were included. Patient files were studied for occurrence of CME, the presence of risk factors (age, diabetes mellitus, preoperative and postoperative complications) and final postoperative vision outcomes after DSEK. In patients with CME, the time interval between DSEK and the occurrence of CME was noted.

Results:

One-hundred-forty-one eyes of 113 patients were included. Mean age of the population was 72.8 years and 57.4% was female. 16 eyes (11.3%) developed CME; the edema was diagnosed after a mean period of 4.4 months postoperatively. Only age was identified as a risk factor for CME (mean age was 78.4 years in patients with CME vs. 72.0 years in patients without CME; P=0.004). The presence of diabetes mellitus showed a trend towards significance (31.3% of patients with CME had diabetes mellitus vs. 11.9% of patients without CME; P=0.068). No association was found with re-bubbling of a detached graft (6.3% of patients with CME underwent rebubbling, vs. 16.0% of patients without CME; P=0.51). Final best corrected visual acuity after surgery trended to be better in the group without CME (0.58 vs. 0.48, P=0.070), but did not reach statistical significance.

Conclusions:

CME was found in 11.3% of patients undergoing DSEK, which is more often than in earlier studies. The most important risk factor to develop CME was older age. Rebubbling of a detached graft did not seem to influence the occurrence of CME. Final visual outcomes showed a trend to be better in the group without CME. FINANCIAL INTEREST: NONE

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