Spectral-domain optical coherence tomography evaluation of postoperative cystoid macular oedema following phacoemulsification with intraoperative complication

BACKGROUND: To report the rate of cystoid macular oedema (CMO) as detected by spectral-domain optical coherence tomography (SD-OCT) after intraoperative complication during phacoemulsification. The secondary objectives include comparing mean macular thickness and best-corrected visual acuity (BCVA) between those who developed postoperative CMO against those who did not. METHODS: This is a prospective cohort study conducted in a tertiary hospital between July 2009 and June 2010. Serial SD-OCT and BCVA were performed at baseline, 1 week, 6 weeks and 16 weeks postoperatively. RESULTS: Single eyes from 47 subjects were analyzed; of these 16 (34%) eyes developed CMO. In the CMO group, mean macular thickness (±SD) increased sharply by 56 μm from 273 ± 24 μm at baseline to 329 ± 31 μm at 16 weeks; whereas in the non-CMO group, macular thickness showed a slight increase of 14 μm from 259 ± 21 μm to 272 ± 20 μm. In the CMO group, mean BCVA (in logarithm of minimum angle of resolution) improved modestly from 0.92 ± 0.66 to 0.66 ± 0.41 at week 16; while in the non-CMO group, mean BCVA improved markedly from 0.98 ± 0.59 to 0.21 ± 0.13. The two groups differed significantly in mean macular thickness (p < 0.001) and mean BCVA (p < 0.001) at 16 weeks. CONCLUSION: As detection rate of CMO is high, postoperative OCT monitoring for patients with intraoperative complications allows earlier diagnosis and treatment.