A prospective study to evaluate changes in macular thickness after uncomplicated cataract surgery using optical coherence tomography in diabetic patients

Anshu Jamaiyar; Sunil Kumar; Neha Kiran; Rohit Kumar Mahato; Mousmi Anand

doi:10.18203/2320-6012.ijrms20232160

Authors

Anshu Jamaiyar Department of Ophthalmology, RIMS, Ranchi, Jharkhand, India
Sunil Kumar Department of Ophthalmology, RIMS, Ranchi, Jharkhand, India
Neha Kiran Department of Ophthalmology, RIMS, Ranchi, Jharkhand, India
Rohit Kumar Mahato Department of Ophthalmology, RIMS, Ranchi, Jharkhand, India
Mousmi Anand Department of Ophthalmology, RIMS, Ranchi, Jharkhand, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232160

Keywords:

OCT, Central macular thickness, Diabetic retinopathy, Cystoid macular edema

Abstract

Background: The objective of this study is to evaluate the alterations in macular thickness subsequent to cataract surgery in individuals diagnosed with diabetes, utilising optical coherence tomography (OCT) as the imaging modality.

Methods: In this prospective study, a cohort of 150 patients was divided into three equal groups based on their diabetic status and presence of retinopathy. Group 1 consisted of nondiabetic patients, Group 2 consisted of diabetic patients without retinopathy, and group 3 consisted of patients with diabetic retinopathy. All patients underwent cataract surgery using manual small incision cataract surgery (m-SICS) technique. A comprehensive ophthalmological assessment was conducted prior to the surgical procedure. The subjects were monitored on the first day following the surgical procedure, and at 2, 6 and 12 weeks after the operation. During each appointment, a comprehensive ophthalmic assessment and OCT of the macula were conducted.

Results: There was a notable augmentation in foveal thickness at the 6-week mark among individuals diagnosed with diabetic retinopathy, in contrast to those without retinopathy and the control group. In the study, it was observed that 26% of individuals diagnosed with diabetes experienced the occurrence of macular edoema, whereas only 4% of the control group exhibited the same condition.

Conclusions: The postoperative alteration in macular thickness and visual outcomes is contingent upon the individual's diabetic condition, duration of diabetes, and severity of retinopathy. A positive correlation was also observed between the alteration in macular thickness and the levels of HbA1C in individuals diagnosed with diabetes.

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References

Kim SJ, Equi R, Bressler NM. Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography. Ophthalmology. 2007;114(5):881-9.

Mentes J, Erakgun T, Afrashi F, Kerci G. Incidence of cystoid macular edema after uncomplicated phacoemulsification. Ophthalmologica. 2003;217(6):408-12.

Kwon SI, Hwang DJ, Seo JY, Park IW. Evaluation of changes of macular thickness in diabetic retinopathy after cataract surgery. Kor J Ophthalmol. 2011;25(4):238-42.

Ursell PG, Spalton DJ, Whitcup SM, Nussenblatt RB. Cystoid macular edema after phacoemulsification: relationship to blood-aqueous barrier damage and visual acuity. J Cataract Refractive Surg. 1999;25(11):1492-7.

Miyake K, Ibaraki N. Prostaglandins and cystoid macular edema. Survey Ophthalmol. 2002;47:S203-18.

Flach AJ. The incidence, pathogenesis and treatment of cystoid macular edema following cataract surgery. Transactions Am Ophthalmological Society. 1998;96:557.

Tranos PG, Wickremasinghe SS, Stangos NT, Topouzis F, Tsinopoulos I, Pavesio CE. Macular edema. Survey Ophthalmol. 2004;49(5):470-90.

Hee MR, Puliafito CA, Wong C, Duker JS, Reichel E, Rutledge B et al. Quantitative assessment of macular edema with optical coherence tomography. Arch Ophthalmol. 1995;113(8):1019-29.

Goebel W, Kretzchmar-Gross T. Retinal thickness in diabetic retinopathy: a study using optical coherence tomography (OCT). Retina. 2002;22(6):759-67.

Gharbiya M, Cruciani F, Cuozzo G, Parisi F, Russo P, Abdolrahimzadeh S. Macular thickness changes evaluated with spectral domain optical coherence tomography after uncomplicated phacoemulsification. Eye. 2013;27(5):605.

Wang KY, Cheng CK. Central retinal thickness changes and visual outcomes following uncomplicated small-incision phacoemulsification cataract surgery in diabetic without retinopathy patients and nondiabetic patients. Taiwan J Ophthalmol. 2014;4(1):33-9.

Neumaier-Ammerer B, Schmid KE, Binder S. Foveal thickness after cataract surgery-Measurement by optical coherence tomography. Spektrum der Augenheilkunde. 2008;22(5):301-4.

Stunf PS, Vidović VN, Urbančič M, Irman Grčar I, Grčar R, Pfeifer V et al. Evaluation of changes of macular thickness in diabetic retinopathy after cataract surgery. Kor J Ophthalmol. 2011;25(4):238-42.