Correlation of Central Macular Thickness and the Best-Corrected Visual Acuity in Three Months After Cataract Surgery by Phacoemulsification and With Intraocular Lens Implantation

Abstract

Purpose To 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). Methods This 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. Results The 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. Conclusion CME 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.

Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis

“…We reviewed previous studies to help find correlations. Bamahfouz A. has reported that CMT changes correlate with best-corrected vision changes in the first month after phacoemulsification cataract surgery ( 32 ). Greater macular thickness is also reported to be related to worse mesopic visual acuity ( 33 ).…”

Evaluation of Macular Thickness Changes after Uncomplicated Phacoemulsification Surgery in Healthy Subjects and Diabetic Patients without Retinopathy by Spectral Domain OCT

“…Our results are similar to those published by Cagini et al [ 39 ] and Ikegami et al [ 33 ] , who reported a peak in macular thickness 3 months after surgery. Prakash et al [ 34 ] found a peak at 6 weeks, Perente et al [ 40 ] and Bamahfouz et al [ 41 ] at the one-month time point, like Katsimpiris et al [ 31 ] in their control group. On the contrary, Giocanti-Auregán et al [ 42 ] , in diabetic patients without DR, observed a peak macular thickness value at 6 months, whereas Katsimpris et al [ 31 ] did at 12 months.…”