Cystoid macular edema following combined phacoemulsification and vitrectomy for macular hole

Purpose: To evaluate the incidence of cystoid macular edema (CME) in patien ts undergoing either combined or consecutive pars plana vitrectomy (PPV) an d phacoemulsification (PE) for the treatment of macular hole and cataract. Methods: Retrospective review of a consecutive surgical series of 22 patien ts with idiopathic macular holes. Seven patients underwent combined PPV wit h air-fluid-C3F8 gas exchange and PE with intraocular lens insertion; 15 pa tients underwent PE subsequent to PPV. Results: Visual acuity improved by 2 or more lines in 3/7 patients in the c ombined group and in 15/15 in the consecutive group. Of seven patients in t he combined group, two required a second PPV for treatment of the macular h ole and one declined further treatment. Of importance, 3/7 in the combined group and 1/15 in the consecutive group developed clinical and angiographic CME, all treated successfully with sub-Tenon's triamcinolone injections. Conclusions: Both combined PPV/PE and consecutive PPV/PE offer excellent po tential therapeutic benefits for the treatment of idiopathic macular holes. The incidence and pathogenesis of CME must be further investigated.