Incidence and progression of epiretinal membranes in eyes after cataract surgery.

Abstract

PURPOSE:

To assess eye-specific epiretinal membrane (ERM) incidence 3 years after phacoemulsification surgery, and ERM detection bias attributable to cataract.

DESIGN:

Cohort study.

METHODS:

We recruited 1932 cataract surgical patients aged ≥64 years at Westmead Hospital (2004-2007). The surgical eye of each patient was assessed for presence of cellophane reflex or preretinal fibrosis at preoperative and 1-month-postoperative visits, and annually thereafter, using retinal image grading. Agreement on ERM detection between preoperative and 1-month-postoperative visits was assessed using kappa statistics. Cumulative incidence of ERM from 1 month to 3 years postoperatively was estimated using Kaplan-Meier methods and compared to the 5-year incidence of idiopathic ERM in right eyes of age-matched Blue Mountains Eye Study (BMES) participants.

RESULTS:

ERM prevalence was 13.9% among 1394 participants with retinal photographs taken 1 month postoperatively. Of 1040 participants with retinal photographs from both preoperative and 1-month-postoperative visits, ERM was detected in 3.1% and 14.8%, respectively, with low diagnostic agreement (kappa = 0.17). Of 1119 subjects without ERM 1 month post surgery, the 3-year cumulative incidence of ERM was 11.2% (95% confidence interval [CI], 9.4%-13.4%; cellophane reflex 6.6%; preretinal fibrosis 4.2%). The age-standardized 3-year incidence of ERM in the surgical cohort (12.1%, 95% CI 8.6%-16.9%) was higher than the 5-year incidence of the BMES subsample (4.4%, 95% CI 3.0%-6.0%).

CONCLUSIONS:

A substantial under-detection of ERM in eyes before cataract surgery could incorrectly contribute to ERM incidence after surgery. Over 3 years, ERM developed in >10%, including preretinal fibrosis in 4%, of surgical eyes free of ERM 1 month post surgery.

• Authors: Calvin Sze-Un Fong, Paul Mitchell, Elena Rochtchina, Thomas Hong, Tania de Loryn, Jie Jin Wang
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 156 Issue 2 Pg. 312-318.e1 (Aug 2013) ISSN: 1879-1891 [Electronic] United States
• PMID: 23628353 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Cohort Studies
• Disease Progression
• Epiretinal Membrane (diagnosis, epidemiology)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Kaplan-Meier Estimate
• Lens Implantation, Intraocular
• Male
• Middle Aged
• New South Wales (epidemiology)
• Phacoemulsification
• Postoperative Complications
• Prevalence
• Visual Acuity (physiology)