Changes in diabetic macular oedema after phacoemulsification surgery

Abstract

Purpose To quantitatively examine changes in macular oedema after phacoemulsification surgery in eyes with diabetic retinopathy (DR) and in eyes without DR. Methods Thirty-four eyes with DR and 34 eyes with no DR scheduled for phacoemulsification surgery were recruited. Foveal thickness and macular volume were measured using optical coherence tomography preoperatively and at 3, 6, and 12 months postoperatively. Grade of diabetic macular oedema was also examined. Results Preoperatively, there were no significant differences between groups in foveal thickness and macular volume. The foveal thickness increased by 20.3% in the DR group and by 6.0% in the no DR group at 3 months after surgery, but thereafter decreased gradually. When comparing the groups, the foveal thickness and macular volume were significantly greater in the DR group than in the no DR group at 3 months postoperatively. The grade of macular oedema worsened in eight eyes (23.5%) in the DR group, and in one (2.9%) in the no DR group: the incidence was significantly greater in the DR group (P ¼ 0.0272). However, the oedema that occurred after surgery resolved spontaneously in three (33.3%) of the nine eyes. Conclusions The degree of diabetic macular oedema increases up to 3 months after cataract surgery, but thereafter decreases gradually. Grade of diabetic macular oedema also worsens up to 3 months, but certain percent of macular oedema that occurs after surgery resolves spontaneously. These changes are more prominent in eyes with DR than in eyes with no DR.

Effect of intravitreal triamcinolone acetonide injection on central macular thickness in diabetic patients having phacoemulsification

“…The 5 eyes not receiving triamcinolone had a mean of 156 mm and 84 mm, respectively. In the study by Hayashi et al, 24 foveal thickness increased by 20.3% 3 months after cataract surgery in patients with diabetic retinopathy. Thereafter, the change decreased (16.8% at 6 months; 7.6% at 12 months).…”

Pseudophakic cystoid macular edema

“…Eyes with diabetic maculopathy have a higher risk of developing PCME [8,11]. It may be difficult to distinguish PCME from progression of diabetic macular edema (DME).…”

Progression of Diabetic Retinopathy and Maculopathy After Phacoemulsification Surgery

“…12 Mentes et al 13 reports an incidence of pseudophakic CME of 9.1% after uneventful phacoemulsification in eyes of nondiabetes patients. Hayashi et al 14 reported that the grade of macular edema (including diffuse, focal macular edema, and CME) worsened significantly more in patients with DR (23.5%) compared with patients with no DR (2.9%) when followed prospectively for 1 year after uneventful phacoemulsification. Incidence of CME was 8.8% at 3 months that persisted at 6 months and regressed to 2.9% at 1 year.…”

“…9,11 However, controversy remains as to whether the CSME seen after cataract surgery is related to surgery or to the natural course of the disease itself. [3][4][5][6][7][8][9]11,14 To answer this question, we again systematically reviewed the 5 prospective case control studies (Table 1). [4][5][6][7][8] The authors reported no significant difference in occurrence of CSME and or CME in 4 of these studies, 4-7 and increased incidence in only 1 study.…”