A long-term follow-up study of cystoid macular edema in aphakic and pseudophakic eyes.

Forty-four aphakic and 45 pseudophakic eyes with typical cystoid macular edema following cataract surgery were reevaluated one to four years following their initial fluorescein angiograms in an effort to compare the natural courses of the macular lesions in the two groups of eyes. Both aphakic and pseudophakic eyes in which the edema was associated with vitreous adhesions to the cataract wound experienced a lower rate of resolution than comparable cases without such adhesions. Macular edema cleared significantly more frequently in aphakic eyes than in pseudophakic cases. Pseudophakic eyes in which iris fixation had been employed had a particularly poor prognosis, which was significantly worse than the natural course observed in pseudophakic eyes associated with capsular fixation. The latter group of eyes cleared significantly less frequently than did the group of aphakic eyes without vitreous adhesions. The reasons that the natural course of cystoid macular edema in pseudophakic eyes is relatively poor are unknown, but chronic inflammation may play a significant role in the pathogenesis of this important complication.