Clinically significant CME occurs infrequently
after routine uncomplicated small-incision cataract
surgery with a peak incidence at 4–6 weeks after
surgery [40&]. A review of cataract surgery complications
in the United States Veterans Affairs system
from 2005 to 2007 reported an incidence of 3.3% for
all cases of diagnosed CME [43&]. There is no standard
protocol for prophylaxis and diagnosis is frequently
made by OCT. Although it generally
responds well to medical therapy, recalcitrant cases
may be associated with permanent impairment of
central visual acuity. The incidence of postoperative
CME is higher in uveitic patients and has been
reported between 4 and 21%. Those with preexisting
macular lesions, such as epiretinal membrane or
macular edema, have a higher risk for poor visual
outcome after cataract surgery [55,56]. Ideally,
patients should demonstrate control of uveitis for
3 or more months prior to cataract surgery and be
given perioperative oral corticosteroids to lower
incidence of postoperative CME [57].