Incidence of fluorescein angiography-proven cystoid macular edema after 4-point Gore-Tex scleral fixation of the Akreos AO60 intraocular lens.

PURPOSE: To determine the incidence of fluorescein angiography (FA)-proven cystoid macular edema (CME) and visual outcomes after 4-point Gore-Tex scleral fixation of the Akreos AO60 intraocular lens (IOL).

SETTING: Tertiary medical center.

DESIGN: Retrospective case series.

METHODS: 172 eyes undergoing pars plana vitrectomy and 4-point Gore-Tex scleral fixation of the Akreos AO60 IOL were reviewed. All patients underwent postoperative FA and optical coherence tomography (OCT) CME evaluation. CME was classified as Group 1, FA-positive only (subclinical); Group 2, FA-positive and OCT-positive (central subfield thickness [CST] >320 μm); and Group 3, FA-positive and OCT-positive with visual loss. Corrected distance visual acuity (CDVA), CST, and intraocular pressure (IOP) were recorded. CME's relationship with transient postoperative hypotension was assessed.

RESULTS: CME was detected in 44 of 172 eyes (25.6%); of these, 24 (55%) were FA-only, 12 (27%) were FA-detected and OCT-detected without visual loss, and 8 (18%) were FA-detected and OCT-detected with visual impairment. Transient ocular hypotension occurred more frequently in eyes with CME (24%) than without CME (3.1%) (10/44 vs 4/128, P = .0009). Mean CDVA improved from 1.34 ± 0.89 logMAR preoperatively to 0.39 ± 0.48 logMAR postoperatively ( P < .001). Eyes without CME demonstrated greater improvement (0.28 logMAR at 3 months; 0.26 logMAR at 12 months) than those with CME.

CONCLUSIONS: 4-point Gore-Tex scleral fixation of the Akreos AO60 IOL improved visual outcomes but showed higher FA-detected CME rates than OCT-based reports. FA detects subclinical CME early, and CME's association with transient ocular hypotension underscored the importance of IOP control and multimodal imaging surveillance.