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Objective: To study central macular thickness before and after uncomplicated phacoemulsification cataract surgery in diabetic patients, comparing between those with and without diabetic retinopathy, in order to estimate the incidence of developing macular edema post procedure.
Methods: Patients who underwent uncomplicated phacoemulsification cataract surgery were enrolled from March 2017 to May 2018, excluding those with preoperative retinal diseases. Central macular thickness (CMT) and best corrected visual acuity were obtained preoperatively and at 4 weeks. Forty-two diabetic patients with no diabetic retinopathy (no DR) and 23 diabetic patients with diabetic retinopathy (DR) who underwent phacoemulsification with intraocular lens insertion were enrolled. Central macular thickness were measured with Spectral domain OCT. These parameters were recorded before phacoemulsification cataract surgery and four-week after cataract operation, and were analyzed using descriptive statistics.
Results: Of the 65 patients, there were 40 males (62%) and 25 females (38%), mean age was 67±8.12 years. Forty-two diabetic patients had no DR and 23 diabetic patients had DR. There was no difference in preoperative CMT between the two groups. All eyes in this study had no macular edema prior to surgery. Phacoemulsification with posterior chamber intraocular lens implantation were performed in all eyes. No intraoperative complications were found. Mean duration from surgery date to postoperative OCT were 33 and 36 days in the no DR and DR group, respectively. Mean postoperative CMT were 235.67 ± 27.59 and 239.04 ± 29.68 µm in the no DR and DR group, respectively (p-value = 0.68). Mean CMT increase over the preoperative study 5.57 ± 12.28 µm (2.40%) in the no DR group and 5.26 ± 7.67 µm (3.28 %) in the DR group. The incidence of ME on OCT (CRT>300 µm) was 1.54%.
Conclusion: CMT in diabetic patients measured by OCT increased after uncomplicated phacoemulsification at 4 weeks in both groups but no statistically significant difference between the no DR and DR groups.
Keywords: macular edema, after cataract surgery, OCT macula, central macular thickness, CMT, phacoemulsification, diabetic retinopathy, DM
Ethics: This study was approved for ethical research in human with the human research ethics committee of Thammasat university, Thailand (Research ID : MTU-EC-OP-6-016/60)
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