To determine the incidence, risk factors, and visual outcomes of cystoid macular edema (CME) after cataract surgery in the United States.
Retrospective longitudinal case-control study.
Patients ≥18 years who underwent phacoemulsification cataract surgery.
The American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) was used to analyze patients who underwent cataract surgery between 2016-2019. Patients who received a diagnosis of CME within 90 days after cataract surgery were classified as cases while the rest were classified as controls. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for risk factors associated with the development of CME as well as poor visual outcome (defined as a best-recorded visual acuity worse than 20/40 Snellen equivalent at postoperative month 12).
Incidence, demographics, baseline characteristics, and visual outcomes.
Out of 3.1 million cataract surgeries performed during the study period, CME was diagnosed in 25,595 eyes (0.8%), with an average onset of 6 weeks. Patients with CME were more likely to be male, <65 years old, Black, and have preexisting diabetic retinopathy. Patients with CME were more likely to have a poor visual outcome (OR 1.75; 95% CI 1.66-1.84; p<0.001), with a mean best-recorded visual acuity of 20/30 at postoperative month 12 (compared to 20/25 for those without CME; p<0.001). Other factors associated with a poor visual outcome included smoking, Medicaid insurance, non-White race, and baseline ocular comorbidities such as macular degeneration and retinal vein occlusion.
While the incidence of CME after cataract surgery is low and while most eyes achieve a visual acuity of 20/40 or better, there are significant outcome disparities that warrant further exploration.

Copyright © 2023. Published by Elsevier Inc.