Comparison of postoperative macular thickness in diabetic patients after phacoemulsification or manual small-incision cataract surgery

Abstract

Objective To compare the macular central foveal thickness in cataract patients with type Ⅱ diabetes after phacoemulsification or manual small incision cataract surgery.Methods Fifty-six eyes of 56 cataract patients with type Ⅱ diabetes were randomly divided into two groups.Patients were treated by phacoemulsificaiton or manual small incision cataract surgery,respectively.All patients underwent fundus examination and fundus photography before operation.The foveal thickness measurement by OCT was performed on 1 month before surgery and 1 week,4 weeks,6 weeks and 3 months after operation.The correlation between foveal thickness and postoperative best corrected visual acuity was analyzed.Results The manual small incision cataract surgery was performed on 26 eyes and phacoemulsification cataract surgery was performed on 30 eyes.No significant difference in postoperative macular edema was found between the two groups.One week after operation,compared with the phacoemulsification group,the retinal neuroepithelial thickness in central fovea of macula in manual small incision surgery group was significantly higher (t =4.602,P =0.006),the best corrected visual acuity was significantly lower (x2 =9.753,P =0.009).Four weeks after operation,neither the retinal neuroepithelial thickness nor the best corrected visual acuity between two groups was significantly different.A negative correlation was found between the postoperative retinal neuroepithelial thickness and the best corrected visual acuity.Conclusion Although the incidence of postoperative macular edema in the two groups was not significantly different from each other,the postoperative retinal neuroepithelial thickness and the best corrected visual acuity were obviously infected by manual small incision surgery in short term after operation. Key words: Diabetics, type Ⅱ ; Surgery, cataract, small incision, manual; Phacoemulsificaiton; Thickness, foveal