A vitrectomised eye has nearly four times the risk of cystoid macular oedema after cataract surgery

The edition in brief

Using a US federated electronic health record network, a retrospective cohort compared cystoid macular oedema after cataract surgery in eyes with and without a pars plana vitrectomy performed at least six months earlier, excluding pre-existing oedema and known risk factors. Among 7,318 propensity-matched pairs, cystoid macular oedema occurred in 4.59 per cent of previously vitrectomised eyes against 1.23 per cent of controls — absolute difference 3.36 per cent (95% CI 2.82 to 3.90), risk ratio 3.73 (2.97 to 4.70). The excess held for vitrectomy done for retinal detachment (5.65 vs 1.22 per cent) and for other indications (3.99 vs 1.23 per cent), and after excluding all intraoperative and postoperative cataract surgery complications. An American Academy of Ophthalmology evidence report reviewed 26 studies of neurodevelopmental outcomes after anti-VEGF versus laser photocoagulation for retinopathy of prematurity, covering treatment from 2006 to 2022 across 39 countries: 20 of 26 studies, including all three randomised trials, found no significant difference, with four favouring laser and two favouring anti-VEGF, and no difference in intelligence quotient in the five studies testing beyond age four. A study of glaucoma incidence across the China Kadoorie Biobank and UK Biobank found more than 68 per cent of over 9,000 incident cases lacked subtype specification; polygenic risk scores indicated that in the Chinese cohort this unspecified group aligned closely with angle-closure glaucoma. And a randomised trial of 68 eyes found phaco-iStent inject and phaco-Kahook Dual Blade goniotomy reduced intraocular pressure by about 14 per cent each with no difference between them.