Abstract
PurposeTo estimate the incidence of central macular edema (CME) following cataract surgery and to correlate the central macular thickness (CMT) to the best-corrected visual acuity (BCVA).MethodsThis cohort study in 2018-2019 included cataract grades I and II. They were operated by phacoemulsification and intraocular lens implantation. CMT was measured using spectral-domain optical coherence tomogram (OCT) before and for three months at one-month intervals after surgery. The change in BCVA and CMT were correlated at three months after surgery. Incidence of CME (more than two SD of pre-surgery CMT) was calculated.ResultsThe mean CMT for 138 eyes operated for cataracts measured before and at one, two, and three months after uneventful surgery was 213 ± 24.9, 222.7 ± 25.5, 217.8 ± 34.8, and 215 ± 28.3 µ, respectively. The median BCVA at three follow-ups was 0.2 (interquartile range [IQR] 0.1; 0.2), 0.1 (IQR 0.0; 0.1), and 0.0 (0.0; 0.03), respectively. The incidence of CME at one and three months was 18% and 4.3%, respectively. The CMT and VA (LogMAR) one month after cataract surgery were significantly correlated (r = 0.4, Pearson P < 0.001). The visual improvement between one and two months post-surgery was not significantly correlated with CMT decline (r = 0.06, Pearson P = 0.5). The BCVA at one, two, and three months was 0.0 LogMAR in 28 (20.3%), 52 (37.7%), and 104 (75.4%) eyes, respectively. Linear regression model, age and diabetes are the risk factors at one month. At two and three months, no significant risk factors were found.ConclusionCME post-cataract surgery seems to be transient. CMT changes correlate with best-corrected vision changes and seem to be affected by age and presence of diabetes in the 1st month after surgery.
Highlights
Cataract surgery using the phacoemulsification method and implantation of an intraocular lens within the capsular bag has been the most widely used surgical procedure by ophthalmologists during this decade [1]
Detection of increased macular thickness as well as cystoid macular edema after cataract surgery in eyes with and without diabetes is efficient with the help of optical coherence tomography [6]
We studied the incidence of central macular edema (CME) measured by optical coherence tomogram (OCT) at three monthly follow-ups after conventional cataract surgeries in eyes without ocular comorbidities during 2017-2019 and correlated with the best-corrected visual acuity (BCVA)
Summary
Cataract surgery using the phacoemulsification method and implantation of an intraocular lens within the capsular bag has been the most widely used surgical procedure by ophthalmologists during this decade [1]. Any factor that could hamper the patient’s vision after successful modern cataract surgery must be identified through audit and addressed [3]. Use of topical anti-inflammatory eye drops for three months following cataract surgery has been found to be effective in reducing vision loss due to macular edema [5]. Detection of increased macular thickness as well as cystoid macular edema after cataract surgery in eyes with and without diabetes is efficient with the help of optical coherence tomography [6]. The incidence of diabetes among adult Saudi patients who were scheduled for cataract surgery was as high as 37.5% in a province of southern Saudi Arabia [9]. It will be interesting to study the rate of central macular edema (CME)
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