Macular Edema after Cataract Surgery in Diabetic Patients without
Retinopathy
Jurečka T., Bátková Z., Ventruba J., Synek S.
Klinika nemocí očních a optometrie FN u sv. Anny a LF Masarykovy univerzity, Brno,přednosta doc. MUDr. S. Synek, CSc. |
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Summary:
Purpose: To study the effect of phacoemulsification on the development of
macular edema and diabetic retinopathy in diabetic patients without
preoperative retinopathy. Patients and methods: This study comprised 86
patients; 26 diabetics, who had no clinically detectable diabetic retinopathy
preoperatively, formed a study group and 60 non-diabetics were included
into the control group. Diabetes mellitus duration, preoperative hemoglobin
A1c level, and diabetes treatment method were recorded in diabetics.
Monocular cataract surgery was performed in all patients. The patients were
clinically assessed with OCT examination preoperatively, and
postoperatively on day 1, in week 1, and in months 1, 2, 3 and 6 respectively.
Foveal, inner macular, outer macular thickness, and macular volume were
analyzed. Results: The increase of the retinal thickness after the cataract
surgery reached maximum in both groups in months 1 and 2. Since month 3
on, there was a progressive decrease in abnormal retinal thickness. There
was a significant major increase in retinal thickness in diabetics in all
examined areas in month 2 (p<0.05 for fovea and inner macula; p=0.001 for
outer macula and p=0.005 for macular volume changes). Trend toward major
increase in retinal thickness in diabetics was still evident even three months
after the surgery. In no case did a diabetic eye develop clinically detectable
diabetic retinopathy during the follow-up period. The correlation between
hemoglobin A1c level and retinal thickness changes in diabetics was not
significant. There was also no significant difference in final visual acuity
between diabetics and non-diabetics.
Conclusion: We can expect similar induced retinal thickness changes in
diabetics without retinopathy as in non-diabetics after uneventful cataract
surgery, though there was a trend toward major increase in retinal thickness in
diabetics.
Key words:
cystoid macular edema, diabetes mellitus, optical coherent
tomography, cataract surgery, phacoemulsification
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