Non-central-involved DME increases risk of central-involved macular edema after cataract surgery

This prospective, multicenter observational study found that the presence of non-central-involved diabetic macular edema (DME) immediately prior to cataract surgery or a history of DME treatment may increase the risk of developing central-involved macular edema 16 weeks after cataract extraction.

The study was conducted by the Diabetic Retinopathy Clinical Research Network (DRCR.net) at 45 clinical sites throughout the United States. Subjects were 293 patients with diabetic retinopathy without definite central subfield thickening on OCT who underwent cataract surgery. Their median age was 65 years and median visual acuity was 20/40. Forty-four percent of eyes had a history of treatment for DME.

At 16 weeks postop, none of the 17 eyes without preoperative DME had central involved macular edema. However, 10 percent of the 97 eyes with non-central-involved DME and 12 percent of the 147 eyes with possible central-involved DME progressed to central-involved macular edema. Also, history of DME treatment was significantly associated with central-involved macular edema development (P < 0 .001).

The authors conclude that clinicians should continue to maintain vigilance in diabetic patients after cataract extraction even when central macular edema is not present immediately prior to cataract surgery, especially in eyes with prior DME treatment or non-central-involved DME.