Eyeworld

22 | EYEWORLD | OCTOBER 2019 ASCRS NEWS EYEWORLD JOURNAL CLUB showed a significant increase in CMT detected by OCT from baseline to 1 month post-cataract extraction, but no significant difference in CMT from baseline to 3 months postop. The DC group showed no significant difference in CMT from baseline to 1 month and 3 months postop. Regarding secondary outcomes, no differences in prevalence of clinical PME, incidence of a significant increase in CMT, and IOP reduc- tion were found between latanoprost and DC groups at 1 month and 3 months postop. Visual acuity improvement occurred significantly more in DC group compared to latanoprost group at 1 month and 3 months postop. The number of medications significantly decreased in the latanoprost group at 1 and 3 months postop. The conclusion of this study was that although latanoprost was associated with a significant increase in CMT at 1 month, there was no difference in CMT at 3 months, indi- cating that latanoprost is relatively safe for use after cataract surgery. The authors suggest that that PGAs can be continued after uneventful cataract surgery. However, the authors do note there was less improvement in visual acuity in PGA users after at 1 month postop and to a lesser extent 3 months postop, which they attributed to transient increase in CMT. They hypothesized that this difference in visual acuity compared to non-PGA users would dissipate if comparing visual acuity at 6 months or later af- ter surgery, because the transient CMT resolves and visual acuity improves. The strengths of this study lie in its design as a randomized clinical trial and that it was single masked. From a methodology standpoint, this decreases bias related to confounding fac- tors via a control group, selection bias via randomization, and interpretation bias via masking. Furthermore, study participants theoretically would comprise good and poor responders to interventions, so that the average therapeutic response is mitigated. All of the operations were performed by the same ex- pert surgeon, minimizing variability in surgical technique and ability. An additional strength is that recruited eyes did not have risk factors for the development of PME in cases with uneventful cataract surgery. The study also assessed patients at appropriate time points for the development of PME. Follow-up was at 1 and 3 months postop, which falls within the continued from page 20 References 1. Henderson BA, et al. Clinical pseudophakic cystoid mac- ular edema. Risk factors for development and duration after treatment. J Cataract Refract Surg. 2007;33(9):1550–1558. 2. Irvine SR. A newly defined vitreous syndrome following cat- aract surgery. Am J Ophthalmol. 1953;36:599–619. 3. Gass JDM, Norton EWD. Fluo- rescein studies of patients with macular edema and papilledema following cataract extraction. Trans Am Ophthalmol Soc 1966;64:232–249. 4. Loewenstein A, Zur D. Postsur- gical cystoid macular edema. Dev Ophthalmol. 2010;47:148–159. 5. Belair ML, et al. Incidence of cystoid macular edema after cataract surgery in patients with and without uveitis using optical coherence tomography. Am J Ophthalmol. 2009;148(1):128– 135. 6. Perente I, et al. Evaluation of macular changes after uncom- plicated phacoemulsification surgery by optical coherence tomography. Curr Eye Res. 2007;32(3):241–247. 7. Flach AJ. The incidence, patho- genesis and treatment of cystoid macular edema following cataract surgery. Trans Am Ophthalmol Soc. 1998;96:557–634.

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