Purpose: To determine the incidence of fluorescein angiography (FA)–proven cystoid macular edema (CME), and visual outcomes following four-point Gore-Tex scleral fixation of the Akreos AO60 intraocular lens (IOL). Setting: Tertiary medical center Design: Retrospective case series Methods: Reviewed 172 eyes undergoing pars plana vitrectomy and four-point Gore-Tex scleral fixation of the Akreos AO60 IOL. All patients underwent postoperative FA and optical coherence tomography (OCT) CME evaluation. CME was classified as: Group 1, FA-positive only (subclinical); Group 2, FA- and OCT-positive (central subfield thickness (CST) >320 μm); and Group 3, FA- and OCT-positive with visual loss. Best-corrected visual acuity (BCVA), CST, and intraocular pressure (IOP) were recorded. CME’s relationship with transient postoperative hypotension was assessed. Results: CME was detected in 44 of 172 eyes (25.6%); of these, 24 (55%) were FA-only, 12 (27%) were FA and OCT-detected without visual loss, and 8 (18%) were FA- and OCT-detected with visual impairment. Transient ocular hypotension occurred more frequently in eyes with CME (24%) than without CME (3.1%) (10/44 vs 4/128, P=.0009). Mean BCVA improved from 1.34 ± 0.89 logMAR preoperatively to 0.39 ± 0.48 logMAR postoperatively (P<.001). Eyes without CME demonstrated greater improvement (0.28 logMAR at 3 months; 0.26 logMAR at 12 months) than those with CME. Conclusions: Four-point Gore-Tex scleral fixation of the Akreos AO60 IOL improved visual outcomes but showed higher FA-detected CME rates than OCT-based reports. FA detects subclinical CME early, and CME’s association with transient ocular hypotension underscores the importance of IOP control and multimodal imaging surveillance.
Chalam et al. (Tue,) studied this question.