Cataract surgery and retinal vein occlusion: Is there an association?

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Abstract

Purpose

To describe and characterise patients who were noted to have developed postoperative retinal vein occlusion (RVO) soon after cataract surgery and to hypothesise the underlying mechanism of such manifestation

Methods

All the patients who developed post-operative retinal vein occlusion (RVO) soon after cataract surgery between April 2012 and April 2013 in Cumberland Infirmary, Carlisle, United Kingdom, were consecutively recruited. All cataract surgeries were performed under topical anaesthesia. All the patients were assessed pre-operatively and 4 weeks after the cataract surgery.

Results

A total of 3 patients were included in this study. All 3 patients were male and mean age of the cohort was 82 ± 10 years. The mean preoperative best-corrected visual acuity (BCVA) of the cohort was 78.3 ETDRS letters. Vasculopathic risk factors were identified in all patients, including previous RVO (66%), hypertension (100%), diabetes (33%) ischemic heart disease (33%) and smoking (66%). All patients underwent phacoemulsification with IOL implantation without any complication. Time interval between surgery and diagnosis of RVO was 73.3 ± 39.7 days. Postoperative BCVA of the cohort was 50 ETDRS letters. Two patients required 0.7mg intravitreal dexamethasone implant (Ozurdex).

Conclusion

Vasculopathic risk factors were identified in all the patients who were noted to develop RVO following cataract surgery. We hypothesise that the fluctuation of intraocular pressure during cataract surgery predisposes to the development of intra-operative retinal vein occlusion in our cohort. Preoperative counselling regarding the risk of RVO before the cataract surgery may be indicated.

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