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

Abstract

Purpose: To assess differences in the evolution of macular thickness after uncomplicated phacoemulsification surgery between non-diabetic subjects and patients with diabetes mellitus (DM) without diabetic retinopathy (DR), using Spectral Domain OCT (SD-OCT). Methods: We performed a unicentric prospective study including one hundred and thirty-one eyes of 70 patients divided into two groups—34 well-controlled DM patients without DR and 36 non-diabetic subjects—who underwent phacoemulsification for cataract surgery. Eyes that developed pseudophakic cystoid macular edema (PCME) were excluded from the study, leaving us with 64 patients. Macular thickness was analyzed using Cirrus HD-OCT (Macular Cube 512 × 128 protocol) preoperatively and on postoperative days 7, 30, 90, and 180. For cases with information available for both eyes, one eye was randomly selected for analysis. Results: A total of 64 eyes from 64 patients were analyzed in this study. The mean value of HbA1c in the diabetic group was 7%. After uncomplicated cataract surgery, patients showed no increase of the foveal, parafoveal, and perifoveal retinal thickness on postoperative day 7. However, thickness values increased on days 30, 90, and 180 after surgery in both groups, and peak at 90 days. There was no difference in macular thickness before or after surgery between DM and non-diabetic patients (p = 0.540). Conclusion: Macular thickness increases up to 6 months after uncomplicated cataract surgery in both DM patients without DR and non-diabetic subjects, with no differences between increases in both groups.

Correlation between Severity of Idiopathic Epiretinal Membrane and Irvine–Gass Syndrome

“…In this study, only patients with diabetic retinopathy were excluded, while patients with diabetes mellitus (DM) were not excluded. Segura et al [ 33 ] conducted a study comparing macular thickness changes after uncomplicated phacoemulsification surgery, featuring two groups: a DM group without diabetic retinopathy and a non-DM group. The authors found increased macular thickness in both groups, yet discerned no significant differences between them.…”

Assessment of the Retinal Ganglion Cell Layer after Uncomplicated Cataract Surgery

“…A recently demonstrated risk factor is a central macular thickness >260. 5 µm measured with OCT before cataract surgery, which increases the probability of developing intraretinal cysts by 9.08 times [6]. Some studies have demonstrated that alterations of the ganglion cell layer thickness (GCLT), inner nuclear layer (INL), and Muller cells layer are produced in PCME with posterior GCL atrophy.…”

“…Clinically significant PCME can lead to visual acuity impairment and morphologic alterations in OCT; its incidence in the last decade has ranged from 0.02 to 4.2% after uncomplicated phacoemulsification [ 4 ]. Macular thickness increases up to 6 months after uncomplicated cataract surgery in both diabetes mellitus (DM) patients without diabetic retinopathy (DR) and non-diabetic subjects [ 5 ].…”