Incidence and risk factors for macular oedema after primary rhegmatogenous retinal detachment surgery: a prospective single‐centre study

Abstract

Abstract Purpose To assess the incidence of cystoid macular oedema (CME) diagnosed by spectral domain optical coherence tomography (SD‐OCT) after primary rhegmatogenous retinal detachment (RRD) surgery. Methods From April 2016 to October 2017, 150 eyes of 150 patients presenting with primary RRD were included consecutively in this prospective single‐centre study. Patients with the following characteristics were excluded: previous vitreoretinal surgery, combined cataract surgery, preoperatively presentation with any intraocular or systemic inflammatory condition, visible macular oedema or epiretinal membrane (ERM) on funduscopy. SD‐OCT (Spectralis, Heidelberg Engineering) was conducted 3 and 6 weeks after surgery. Results One hundred and twenty‐eight of the 150 patients completed the study, of whom 107 (age: 61.7 ± 11.5 years, mean ± SD) showed successful retinal attachment during follow‐up visits. The most frequent operation method was scleral buckling (54.2%), followed by vitrectomy (25.2%) and the combination of both techniques (20.6%). Postoperative SD‐OCT revealed CME, neurosensory detachment and ERM in 18.7, 31.8 and 32.7% of all cases, respectively. The risk of postoperative CME was significantly elevated in patients with ERM (42.9 versus 6.9%, p < 0.001). In addition, patients with initial detachment of the macula had more postoperative CME (26.5 versus 11.1%, p = 0.044). BCVA improvement was significantly lower in patients with CME compared to patients without 6 weeks after surgery for macula‐on RRD. Conclusions This prospective study confirmed that postoperative CME is a frequent complication after RRD surgery; we identified ERM and macula‐off RRD as potential risk factors. As CME potentially delays visual recovery, postoperative follow‐ups should include SD‐OCT.