Risk Factors and Cumulative Incidence of Cystoid Macular Edema After Simple Cataract Surgery: A Systematic Review and Meta-Analysis.

Pseudophakic cystoid macular edema (PCME) is a common side effect following cataract surgery, especially in patients with systemic and/or ocular comorbidities. Research evidence has established the impact of cataract surgery on PCME occurrence; various risk factors could contribute to PCME development, as indicated by epidemiological studies. This research aims to examine the cumulative incidence of PCME and explore the correlation between PCME occurrence, ophthalmic, systemic, and surgery-related risk factors after uncomplicated cataract surgery. PubMed and EMBASE databases were used for this systematic search (end-date of search: March 31, 2024). Random-effects (DerSimonian-Laird) models were used to estimate the pooled cumulative incidence, pooled relative risk (RR), and 95% confidence intervals (95% CIs). Subgroup analyses, sensitivity analyses, and meta-regression analyses were also carried out. The meta-analysis concerning cumulative PCME incidence included 143 studies. Thirty-seven studies were included in a meta-analysis of possible PCME risk factors. Pooled cumulative PCME incidence was found to be 5%. PCME was more frequent in patients with diabetes mellitus (DM) (RR=2.87, 95%Cl: 1.96-4.21), epiretinal membrane (ERM) (RR=4.51, 95%Cl: 3.06-6.64), uveitis (RR=6.76, 95%Cl: 2.49-18.31), pars plana vitrectomy (PPV) (RR=4.11, 95%Cl: 1.86-9.11) and retinal vein occlusion (RVO) (RR=8.79, 95%Cl: 1.90-40.76). DM, ERM, uveitis, PPV, and RVO were associated with PCME. Additional prospective cohort studies investigating various risk factors seem desirable.