To investigate the risk of developing cystoid macular edema (CME) after cataract surgery in patients with a history of pars plana vitrectomy (PPV).
Approach:
Study Design: A retrospective cohort study analyzing electronic health records from the TriNetX US Network, including 615,983 adults who underwent cataract surgery.
Patient Selection: Included 7,422 patients with prior PPV, excluding those with pre-existing CME or retinal conditions.
Data Analysis: Used propensity score matching to create 7,318 matched pairs for comparison.
Key Findings:
CME occurred in 4.59% of patients with prior PPV compared to 1.23% of controls, indicating a relative risk of 3.73 and an absolute difference of 3.36 percentage points.
Among patients with PPV for retinal detachment, CME rates were 5.65% versus 1.22% in controls.
For non-retinal-detachment indications, CME rates were 3.99% compared to 1.23% in controls.
The increased risk of CME persisted even after excluding intraoperative or postoperative complications.
Limitations:
Potential surveillance bias due to closer follow-up in previously vitrectomized patients.
Reliance on diagnostic and procedural codes without laterality data.
Possible residual confounding and lack of visual-acuity outcomes.
