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EW RESIDENTS 72 byline goes here plus fade February 2017 progression after phacoemulsification: prospective study. J Cataract Refract Surg. 2006;32:1438–1444. 3. Kim SJ, et al. Analysis of macular ede- ma after cataract surgery in patients with diabetes using optical coherence tomography. Ophthalmology. 2007;114:881–889. 4. Kato S, et al. Influence of phacoemulsifi- cation and intraocular lens implantation on the course of diabetic retinopathy. J Cataract Refract Surg. 1999;25:788–793. 5. Zaczek A, et al. Visual outcome after phacoemulsification and IOL implanta- tion in diabetic patients. Br J Ophthalmol. 1999;83:1036–1041. 6. Squirrell D, et al. A prospective, case controlled study of the natural history of diabetic retinopathy and maculopathy after uncomplicated phacoemulsification cataract surgery in patients with type 2 diabetes. Br J Ophthalmol. 2002;86:565–571. Contact information Pettey: jeff.pettey@hsc.utah.edu further tested or employed in future studies. We applaud Yang et al. for their methodical and novel approach in evaluating CME. Despite some of the possible shortcomings in this study, Yang et al. did describe a new diagnostic classification system for CME based on OCT and microper- imetry. This study adds to recent ME research investigating the reliability of OCT and other less invasive ancil- lary tests than FA to better identify csCME. EW References 1. Diabetic Retinopathy Clinical Research Network Authors/Writing Committee. Macular edema after cataract surgery in eyes without preoperative central-involved diabetic macular edema. JAMA Ophthalmol. 2013;131:870– 879. 2. Romero-Aroca P, et al. Nonproliferative diabetic retinopathy and macular edema Review continued from page 70 The risk factors and diagnosis of pseudophakic cystoid macular edema after cataract surgery in diabetic patients Jin Yang, MD, PhD, Lei Cai, MD, Zhongcui Sun, MD, PhD, Hongfei Ye, MD, PhD, Qi Fan, MD, PhD, Keke Zhang, MD, Wenyi Lu, Yi Lu, MD, PhD J Cataract Refract Surg. 2017;43(2). Article in press Purpose: To investigate the risk factors and potential diagnostic criteria for pseudophakic cystoid macular edema (PCME) in diabetic patients after phacoemulsification. Setting: Department of Ophthalmology, Eye and ENT Hospital of Fudan University. Design: Prospective nonrandomized study. Methods: The patients with a diagnosis of diabetes were followed up at 1 week, 1 month, 3 months, and 6 months after cataract surgery and examined with optical coherence tomography (OCT), microperimetry and logMAR chart to evaluate their foveal thickness (FT), macular sensitivity (MS), and best corrected visual acuity (BCVA). Correlation analyses, linear regression analyses and unsupervised hierarchical clustering analysis were performed to reveal risk factors and diagnostic criteria for PCME. Results: The duration, type of diabetes, stage of diabetic retinopathy, grading of nuclear opalescence, glycosylated hemoglobin A1c (HbA1c) and ultrasound time were positively correlated with the change of FT and negatively associated with the alteration of MS after cataract surgery. Unsupervised data analysis revealed three groups of subjects: non-PCME, I-PCME, and II-PCME patients. Subclinical I-PCME subjects had a 30–40% increase in FT at 1 month postoperative, while clinical II- PCME patients showed an at least 40% increase in FT and 20% decrease in MS. The incidence of clinical PCME was 3.2% in diabetic patients as per our diagnostic criteria. The change of MS was more temporally consistent and more correlated with FT. Conclusions: Duration, severity and type of diabetes, hardness of lens, and HbA1c confer risk for PCME in diabetic patients after cataract surgery. A ≥40% increase in FT and ≥20% decrease in MS offers an objective and reliable diagnostic standard to report PCME in diabetics.

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