Macular and Subfoveal Choroidal Thickness before and after Phacoemulsification Using Optical Coherence Tomography in Diabetic and Non-Diabetic Patients

Abstract

Introduction: Cataract surgery by phacoemulsification is an invasive procedure that has become the most common intraocular surgery and usually improves the visual outcome. However, it is an inflammatory process to the eye and in many cases can lead to worsening of pre-existing retinal diseases such as diabetic macular edema or development of new diseases such as Irvine-Gass syndrome. This inflammatory response is mostly induced by the release of prostaglandins. Objective: The aim of this study was to evaluate the effect of uneventful phacoemulsification on the morphology and thickness of the macula and the choroid. Patients and Methods: In 30 eyes from 30 patients (15 non-diabetic and 15 diabetic), central retinal macular thickness, and subfoveal choroidal thickness, were measured preoperatively and one month and three months after phacoemulsification using optical coherence tomography. Results: In non-diabetic patients, central macular thickness was 202.80±22.39 μm before phaco and 216.27±23.97 μm after 1 month and 208.13±23.59 μm after 3 months while Subfoveal choroidal thickness was 203.73±28.66 before surgery and 218.80±31.09 after 1 month and 209.20±30.63 after 3 months.In diabetic patients central macular thickness was 233.33±12.74 before surgery and 253.27±15.89 after 1 month and 246.93±22.39 after 3 months while subfoveal choroidal thickness was 233.80±24.14 before surgery and 252.80±26.59 after 1 month and 243.47±24.45 after 3 months. Conclusion: Uncomplicated phacoemulsification induces non pathologic increases in subfoveal choroidal thickness and macular thickness probably due to the inflammatory effect of the surgery but it decreases nearly to normal after 3 months; however these changes are not accompanied by significant decrease in visual acuity.