​​Race, Age Influence Development of Cystoid Macular Edema After Cataract Surgery

In this photo taken on September 27, 2021, a doctor performs free cataract eye surgery on patient Venkatachalam Rajangam at Aravind eye hospital in Madurai in India’s Tamil Nadu state. – Black ticks on their foreheads marking the eye to be operated on, dozens of patients in green overalls wait in line, beneficiaries of a pioneering Indian model restoring eyesight to more people than anywhere else in the world. – TO GO WITH’India-health-social’,FEATURE by Abhaya SRIVASTAVA (Photo by Arun SANKAR / AFP) / TO GO WITH’India-health-social’,FEATURE by Abhaya SRIVASTAVA (Photo by ARUN SANKAR/AFP via Getty Images)
Although a rare postoperative complication, smoking and demographic factors may be associated with higher CME rates.

This article is part of Ophthalmology Advisor’s Focus on Retina coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the retinal experts at the AAO. Check back for more from the AAO 2021 Meeting.


Investigators sought to determine the incidence of cystoid macular edema (CME) in patients after cataract surgery in the United States. Data from this study was presented at the American Academy of Ophthalmology 2021 annual meeting, held in New Orleans from November 12-15. 

Researchers utilized the American Academy of Ophthalmology’s Intelligent Research in Sight (IRIS) Registry containing data from 2013 to 2019 to calculate the frequency of CME diagnoses within 3 months of cataract surgery. Eyes with pre-existing macular edema were excluded from the study. 

In 5,875,940 cataract surgeries that were performed between 2013 and 2019, CME was diagnosed in 32,733 eyes (0.6%) of 28,401 patients ( average age 71 years,51% women). The average time to CME diagnosis was 6 weeks after cataract surgery. Additionally, the investigators reported a mean visual acuity of 20/50 at diagnosis and 20/40 at the last visit, with an average follow-up time of 1 year. 

While the team reported that 38% of eyes had a final visual acuity worse than 20/40, they found that there was a higher likelihood of this for patients in older age groups. Individuals who are Black (P <.001), Hispanic (P <.001), or Asian (P =.01) are also at elevated risk, according to the research. Active smokers also have increased risk. (P <.001). 

Overall, most patients were able to achieve visual acuity of 20/40 or better and the incidence of CME after cataract surgery was generally low. However, the authors note that the reported outcome disparities should be further investigated.  

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Iftikhar M, Dun C, Lum F, Woreta FA. Cystoid macular edema after cataract surgery in the United States: IRIS Registry analysis. Paper presented at: American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021; New Orleans. Abstract PA020.