A Large-Scale Cohort Analysis of Topical Prostaglandin Analog Use and Pseudophakic Cystoid Macular Edema Following Cataract Surgery.

PURPOSE: To evaluate whether perioperative topical prostaglandin analog (PGA) use alters the risk of pseudophakic cystoid macular edema (PCME) following routine cataract surgery.

DESIGN

A retrospective cohort study.

PARTICIPANTS

Patients undergoing cataract surgery, without pre-existing high-risk factors for PCME (such as prior cystoid macular edema, uveitis, or retinal vascular diseases), categorized into three perioperative PGA exposure groups: (1) PGA prescribed within 3 months prior to surgery ("PGA Before"), (2) PGA prescribed within 1 month after surgery ("PGA After"), and (3) PGA prescribed both before and after surgery ("PGA Before & After"). The control group included patients with no PGA prescriptions any time before and 3 months after surgery.

METHODS

The data were collected from the TriNetX United States Collaborative Network. Propensity score matching was conducted to balance demographics, cataract type and surgical complexity, glaucoma type and severity, comorbidities, and concomitant topical and long-term systemic anti-inflammatory medication use between groups. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to assess the 3-month risk of PCME following cataract surgery.

MAIN OUTCOME MEASURES: Three-month incidence of diagnostically significant PCME following cataract surgery.

RESULTS

After matching, 9457 patients were included in the "PGA Before" group and its control, 1993 patients in the "PGA After" group and its control, and 2367 patients in the "PGA Before & After" group and its control. No significant difference in the risk of PCME was observed among those prescribed PGA prior to surgery (HR 1.08, 95% CI: 0.89-1.31), after surgery (HR 1.08, 95% CI: 0.68-1.70), or both before and after surgery (HR 0.86, 95% CI: 0.61-1.23), compared to matched controls.

CONCLUSIONS

Perioperative PGA use before or after cataract surgery was not associated with an increased risk of PCME. These findings provide evidence that PGA use in the perioperative period may not significantly impact the risk of PCME within 3 months postsurgery.

FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.