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. 1981;79:810–839.

A long-term follow-up study of cystoid macular edema in aphakic and pseudophakic eyes.

C P Wilkinson
PMCID: PMC1312204  PMID: 7043873

Abstract

Forty-four aphakic and 45 pseudophakic eyes with typical cystoid macular edema following cataract surgery were reevaluated one to four years following their initial fluorescein angiograms in an effort to compare the natural courses of the macular lesions in the two groups of eyes. Both aphakic and pseudophakic eyes in which the edema was associated with vitreous adhesions to the cataract wound experienced a lower rate of resolution than comparable cases without such adhesions. Macular edema cleared significantly more frequently in aphakic eyes than in pseudophakic cases. Pseudophakic eyes in which iris fixation had been employed had a particularly poor prognosis, which was significantly worse than the natural course observed in pseudophakic eyes associated with capsular fixation. The latter group of eyes cleared significantly less frequently than did the group of aphakic eyes without vitreous adhesions. The reasons that the natural course of cystoid macular edema in pseudophakic eyes is relatively poor are unknown, but chronic inflammation may play a significant role in the pathogenesis of this important complication.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berrocal J. A. Incidence of cystoid macular edema after different cataract operations. Mod Probl Ophthalmol. 1977;18:518–520. [PubMed] [Google Scholar]
  2. Binkhorst C. D. Corneal and retinal complications after cataract extraction. The mechanical aspect of endophthalmodonesis. Ophthalmology. 1980 Jul;87(7):609–617. doi: 10.1016/s0161-6420(80)35183-x. [DOI] [PubMed] [Google Scholar]
  3. CHANDLER P. A. Complications after cataract extraction: clinical aspects. Trans Am Acad Ophthalmol Otolaryngol. 1954 May-Jun;58(3):382–396. [PubMed] [Google Scholar]
  4. DUNNINGTON J. H., REGAN E. F. Late fistulization of operative wounds; diagnosis and treatment. Trans Am Ophthalmol Soc. 1949;47:63–79. [PMC free article] [PubMed] [Google Scholar]
  5. Easty D., Dallas N., O'Malley R. Aphakic macular oedema following prosthetic lens implantation. Br J Ophthalmol. 1977 May;61(5):321–326. doi: 10.1136/bjo.61.5.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fung W. E. Phacoemulsification. Ophthalmology. 1978 Jan;85(1):46–51. doi: 10.1016/s0161-6420(78)35695-5. [DOI] [PubMed] [Google Scholar]
  7. GARTNER S. OPTIC NEURITIS AND MACULAR EDEMA FOLLOWING CATARACT EXTRACTION. Eye Ear Nose Throat Mon. 1964 Feb;43:45–49. [PubMed] [Google Scholar]
  8. Gass J. D., Norton E. W. Cystoid macular edema and papilledema following cataract extraction. A fluorescein fundoscopic and angiographic study. Arch Ophthalmol. 1966 Nov;76(5):646–661. doi: 10.1001/archopht.1966.03850010648005. [DOI] [PubMed] [Google Scholar]
  9. Gass J. D., Norton E. W. Follow-up study of cystoid macular edema following cataract extraction. Trans Am Acad Ophthalmol Otolaryngol. 1969 Jul-Aug;73(4):665–682. [PubMed] [Google Scholar]
  10. Henry M. M., Henry L. M., Henry L. M. A possible cause of chronic cystic maculopathy. Ann Ophthalmol. 1977 Apr;9(4):455–457. [PubMed] [Google Scholar]
  11. Hitchings R. A. Aphakic macular oedema: a two-year follow-up study. Br J Ophthalmol. 1977 Oct;61(10):628–630. doi: 10.1136/bjo.61.10.628. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hitchings R. A., Chisholm I. H., Bird A. C. Aphakic macular edema: incidence and pathogenesis. Invest Ophthalmol. 1975 Jan;14(1):68–72. [PubMed] [Google Scholar]
  13. IRVINE S. R. A newly defined vitreous syndrome following cataract surgery. Am J Ophthalmol. 1953 May;36(5):599–619. doi: 10.1016/0002-9394(53)90302-x. [DOI] [PubMed] [Google Scholar]
  14. Irvine A. R. Cystoid maculopathy. Surv Ophthalmol. 1976 Jul-Aug;21(1):1–17. doi: 10.1016/0039-6257(76)90045-x. [DOI] [PubMed] [Google Scholar]
  15. Irvine A. R. Extracapsular cataract extraction and pseudophakos implantation in primates: a clinico-pathologic study. Trans Am Ophthalmol Soc. 1980;78:780–807. [PMC free article] [PubMed] [Google Scholar]
  16. Jacobson D. R., Dellaporta A. Natural history of cystoid macular edema after cataract extraction. Am J Ophthalmol. 1974 Apr;77(4):445–447. doi: 10.1016/0002-9394(74)90451-6. [DOI] [PubMed] [Google Scholar]
  17. Jaffe N. S. Vitreous traction at the posterior pole of the fundus due to alterations in the vitreous posterior. Trans Am Acad Ophthalmol Otolaryngol. 1967 Jul-Aug;71(4):642–652. [PubMed] [Google Scholar]
  18. KIRSCH R. E., STEINMAN W. Spontaneous rupture of the anterior hyaloid membrane following intracapsular cataract surgery. Am J Ophthalmol. 1954 May;37(5):657–665. doi: 10.1016/0002-9394(54)91218-0. [DOI] [PubMed] [Google Scholar]
  19. Kimball R. W., Morse P. H., Benson W. E. Cystoid macular edema after cryotherapy. Am J Ophthalmol. 1978 Oct;86(4):572–573. doi: 10.1016/0002-9394(78)90310-0. [DOI] [PubMed] [Google Scholar]
  20. Klein R. M., Katzin H. M., Yannuzzi L. A. The effect of indomethacin pretreatment on aphakic cystoid macular edema. Am J Ophthalmol. 1979 Apr;87(4):487–489. doi: 10.1016/0002-9394(79)90235-6. [DOI] [PubMed] [Google Scholar]
  21. Kolker A. E., Becker B. Epinephrine maculopathy. Arch Ophthalmol. 1968 May;79(5):552–562. doi: 10.1001/archopht.1968.03850040554010. [DOI] [PubMed] [Google Scholar]
  22. Kottow M., Hendrickson P. Iris angiography in cystoid macular edema after cataract extraction. Arch Ophthalmol. 1975 Jul;93(7):487–493. doi: 10.1001/archopht.1975.01010020503004. [DOI] [PubMed] [Google Scholar]
  23. Kramer S. G. Considerations on epinephrine therapy in glaucoma. Ann Ophthalmol. 1978 Aug;10(8):1077–1078. [PubMed] [Google Scholar]
  24. Kramer S. G. Cystoid macular edema after aphakic penetrating keratoplasty. Ophthalmology. 1981 Aug;88(8):782–787. doi: 10.1016/s0161-6420(81)34952-5. [DOI] [PubMed] [Google Scholar]
  25. Lobes L. A., Jr, Grand M. G. Incidence of cystoid macular edema following scleral buckling procedure. Arch Ophthalmol. 1980 Jul;98(7):1230–1232. doi: 10.1001/archopht.1980.01020040082010. [DOI] [PubMed] [Google Scholar]
  26. Martin N. F., Green W. R., Martin L. W. Retinal phlebitis in the Irvine-Gass syndrome. Am J Ophthalmol. 1977 Mar;83(3):377–386. doi: 10.1016/0002-9394(77)90737-1. [DOI] [PubMed] [Google Scholar]
  27. Maumenee A. E. Clinical entities in "uveitis": an approach to the study of intraocular inflammation. Trans Am Acad Ophthalmol Otolaryngol. 1970 May-Jun;74(3):473–504. [PubMed] [Google Scholar]
  28. Maumenee A. E. Further advances in the study of the macula. Arch Ophthalmol. 1967 Aug;78(2):151–165. doi: 10.1001/archopht.1967.00980030153008. [DOI] [PubMed] [Google Scholar]
  29. Meredith T. A., Kenyon K. R., Singerman L. J., Fine S. L. Perifoveal vascular leakage and macular oedema after intracapsular cataract extraction. Br J Ophthalmol. 1976 Nov;60(11):765–769. doi: 10.1136/bjo.60.11.765. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Michels R. G., Maumenee A. E. Cystoid macular edema associated with topically applied epinephrine in aphakic eyes. Am J Ophthalmol. 1975 Sep;80(3 Pt 1):379–388. doi: 10.1016/0002-9394(75)90522-x. [DOI] [PubMed] [Google Scholar]
  31. Miyake K. Prophylaxis of aphakic cystoid macular edema using topical indomethacin. J Am Intraocul Implant Soc. 1978 Oct;4(4):174–179. [PubMed] [Google Scholar]
  32. NICHOLLS J. V. Macular edema in association with cataract extraction. Am J Ophthalmol. 1954 May;37(5):665–672. doi: 10.1016/0002-9394(54)91219-2. [DOI] [PubMed] [Google Scholar]
  33. Norton A. L., Brown W. J., Carlson M., Pilger I. S., Riffenburgh R. S. Pathogenesis of aphakic macular edema. Am J Ophthalmol. 1975 Jul;80(1):96–101. doi: 10.1016/0002-9394(75)90877-6. [DOI] [PubMed] [Google Scholar]
  34. Obstbaum S. A., Galin M. A. Cystoid macular oedema and ocular inflammation. The corneo-retinal inflammatory syndrome. Trans Ophthalmol Soc U K. 1979 Apr;99(1):187–191. [PubMed] [Google Scholar]
  35. REESE A. B., CARROLL F. D. Optic neuritis following cataract extraction. Trans Am Acad Ophthalmol Otolaryngol. 1958 Nov-Dec;62(6):765–770. [PubMed] [Google Scholar]
  36. Reese A. B., Jones I. S., Cooper W. C. Macular changes secondary to vitreous traction. Trans Am Ophthalmol Soc. 1966;64:123–134. [PMC free article] [PubMed] [Google Scholar]
  37. Roper D. L., Nisbet R. M. Effect of hyaluronidase on the incidence of cystoid macular edema. Ann Ophthalmol. 1978 Dec;10(12):1673–1678. [PubMed] [Google Scholar]
  38. Ryan S. J., Jr Cystoid maculopathy in phakic retinal detachment procedures. Am J Ophthalmol. 1973 Oct;76(4):519–522. doi: 10.1016/0002-9394(73)90740-x. [DOI] [PubMed] [Google Scholar]
  39. Tolentino F. I., Schepens C. L. Edema of posterior pole after cataract extraction. A biomicroscopic study. Arch Ophthalmol. 1965 Dec;74(6):781–786. doi: 10.1001/archopht.1965.00970040783008. [DOI] [PubMed] [Google Scholar]
  40. Tso M. O., Shih C. Y. Experimental macular edema after lens extraction. Invest Ophthalmol Vis Sci. 1977 May;16(5):381–392. [PubMed] [Google Scholar]
  41. WELCH R. B., COOPER J. C. Macular edema, papilledema, and optic atrophy after cataract extraction. AMA Arch Ophthalmol. 1958 May;59(5):665–675. doi: 10.1001/archopht.1958.00940060049005. [DOI] [PubMed] [Google Scholar]
  42. WELCH R. B., MAUMENEE A. E., WAHLEN H. E. Peripheral posterior segment inflammation, vitreous opacities, and edema of the posterior pole. Arch Ophthalmol. 1960 Oct;64:540–549. doi: 10.1001/archopht.1960.01840010542010. [DOI] [PubMed] [Google Scholar]
  43. West C. E., Fitzgerald C. R., Sewell J. H. Cystoid macular edema following aphakic keratoplasty. Am J Ophthalmol. 1973 Jan;75(1):77–81. doi: 10.1016/0002-9394(73)90655-7. [DOI] [PubMed] [Google Scholar]
  44. Wilkinson C. P., Rowsey J. J. Closed vitrectomy for the vitreous touch syndrome. Am J Ophthalmol. 1980 Sep;90(3):304–308. doi: 10.1016/s0002-9394(14)74908-6. [DOI] [PubMed] [Google Scholar]
  45. Winslow R. L., Taylor B. C., Harris W. S. A one-year follow-up of cystoid macular edema following intraocular lens implantation. Ophthalmology. 1978 Feb;85(2):190–196. doi: 10.1016/s0161-6420(78)35680-3. [DOI] [PubMed] [Google Scholar]
  46. Worst J. Extracapsular surgery in lens implantation (Binkhorst lecture). Part iv. Some anatomical and pathophysiological implications. J Am Intraocul Implant Soc. 1978 Jan;4(1):7–14. doi: 10.1016/s0146-2776(78)80005-6. [DOI] [PubMed] [Google Scholar]
  47. Yannuzzi L. A., Klein R. M., Wallyn R. H., Cohen N., Katiz I. Ineffectiveness of indomethacin in the treatment of chronic cystoid macular edema. Am J Ophthalmol. 1977 Oct;84(4):517–519. doi: 10.1016/0002-9394(77)90444-5. [DOI] [PubMed] [Google Scholar]

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