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.