Evaluation of macular changes after uncomplicated phacoemulsification surgery in diabetic patients using optical coherence tomography

Abstract

Objective The aim of this study was to evaluate the subclinical influence of uncomplicated cataract surgery on foveal thickness and volume in the early postoperative period in diabetic and nondiabetic patients. Background Diabetic patients pose a particular challenge because of the tendency for early formation of cataract in them and propensity to develop macular edema after cataract surgery. Patients and methods A prospective nonrandomized study was carried out on 50 eyes of 43 patients, which were divided into two groups. Group 1 included 25 eyes of diabetic patients and group 2 included 25 eyes of nondiabetic patients. Optical coherence tomography was performed to measure initial and 1-month postoperative mean foveal thickness (MFT). Exclusion criteria were as follows: dense cataract that did not permit the measurement of the central macular thickness, proliferative diabetic retinopathy (DR), chronic uveitis, and any posterior segment pathologies other than nonproliferative DR. Results MFT increased significantly in both groups. In group 1 it increased initially from 254.88 ± 32.53 to 310.52 ± 64.74 at 1 month postoperatively (P = 0.001). In group 2 it increased initially from 228.28 ± 18.65 to 269.16 ± 23.59 at 1 month postoperatively (P = 0.001). There was no difference in initial logarithm of minimal angle of resolution visual acuity between the two groups: in group 1 it was 0.80 ± 0.05 and in group 2 it was 0.80 ± 0.06 (P = 0.801). Postoperative logarithm of minimal angle of resolution visual acuity was significantly different: in group 1 it was 0.43 ± 0.23 and in group 2 it was 0.25 ± 0.11 (P = 0.001). Conclusion Increase in MFT occurred after uncomplicated phacoemulsification in diabetic and nondiabetic eyes; the range of increased MFT was more in diabetic patients with higher initial MFT or higher grade of DR preoperatively.