Cystoid macular edema after endothelial keratoplasty in eyes With prior vitrectomy versus eyes without prior vitrectomy

PurposeTo determine the incidence of cystoid macular edema (CME) within the first 6 months after endothelial keratoplasty (EK) in eyes that had previously undergone vitrectomy versus those without prior vitrectomy.DesignRetrospective cohort study.MethodsA retrospective cohort analysis of the TriNetX database was performed by querying all patients who underwent EK (Descemet stripping automated endothelial keratoplasty or Descemet membrane endothelial keratoplasty) with ≥ 6 months of follow-up between January 1, 2004, and August 30, 2024. Patients with a previous history of diabetic macular edema, uveitis, or retinal vascular occlusion were excluded. Cohorts were stratified based on a history of prior vitrectomy. Propensity score matching (PSM) between cohorts was conducted for age at index, sex, race, ethnicity, and diagnosis of Fuchs endothelial dystrophy. The outcome assessed was the incidence of postoperative CME within 6 months after EK in both groups. Odds ratios were calculated between cohorts.ResultsThe final analysis included 1044 patients, divided into those with (n = 522) and without (n = 522) prior vitrectomy before EK. Patients who had undergone vitrectomy prior to EK were found to develop postoperative CME within 6 months at a significantly higher rate (32 of 522) compared to those who had not undergone vitrectomy (17 of 522) (P = 0.0282; OR 1.94, 95% CI 1.063-3.539).ConclusionPrior vitrectomy appears to be associated with a greater incidence of postoperative CME after EK.