Cystoid macular edema following secondary lens implantation

We reviewed 224 cases that had undergone secondary lens implantation. Cystoid macular edema occurred in 16 (7.1%) cases; edema was transient in 14 (6.3%) cases and permanent in two (0.8%) cases. Three factors seem to affect the incidence of CME: time lapse between cataract extraction and lens implantation; a positive preoperative fluorescein angiogram; and vitreous loss during lens implantation--if implantation is performed within a year of cataract extraction. Two eyes with pre-existing CME and a functional vision of 20/100 or better deteriorated to 20/200 or less after secondary lens implantation due to permanent macula edema. However, the incidence of postoperative CME can be as low as 1.3% if the macula is clear on the preoperative fluorescein angiogram and if surgery is performed no sooner than one year after cataract extraction.