Korean J Ophthalmol.  2011 Aug;25(4):238-242. 10.3341/kjo.2011.25.4.238.

Evaluation of Changes of Macular Thickness in Diabetic Retinopathy after Cataract Surgery

• Kwon SI
• Hwang DJ
• Seo JY
• Park IW

• KMID: 1018410
• DOI: http://doi.org/10.3341/kjo.2011.25.4.238

Abstract

PURPOSE
To assess the macular thickness changes after cataract surgery in diabetic patients using optical coherence tomography (OCT).
METHODS
We retrospectively reviewed the records of 104 diabetic patients who underwent cataract surgery. We examined the changes of macular thickness using OCT before cataract surgery and 1 week, 1-, 2- and 6-months after surgery. The central subfield mean thickness (CSMT) was used to evaluate macular edema which was defined as an increase of CSMT (DeltaCSMT) > 30% from the baseline. The association between prior laser treatment or severity of diabetic retinopathy and macular thickness were also analyzed.
RESULTS
Macular edema occurred in 19 eyes (18%) from the diabetic group and 63% of macular edema developed at 1 month after surgery. Thirteen (68%) out of 19 eyes with macular edema showed the resolution of macular edema by 6 months after surgery without treatment. DeltaCSMT of eyes without a history of laser treatment was statistically greater compared to eyes with a history of laser treatment in at 1- and 2-months after surgery, but was not different than eyes who had laser treatment at 6-months after surgery. The severity of diabetic retinopathy was not significantly correlated to macular edema, but there was statistical difference when patients who had a history of prior laser treatment were excluded.
CONCLUSIONS
The incidence of macular edema after cataract surgery in diabetic patients was 18%. Its peak incidence was at 1 month post surgery and it resolved spontaneously in 68% of patients by 6 months post surgery. Prior laser treatment might prevent postoperative macular edema until 2 months after cataract surgery in diabetic patients. However, macular edema did not affect the severity of diabetic retinopathy.

Keyword

Cataract extraction; Diabetic retinopathy; Macular edema; Macular thickness

MeSH Terms

Aged
Cataract/*complications
*Cataract Extraction
Diabetic Retinopathy/complications/*pathology
Disease Progression
Female
Follow-Up Studies
Humans
Macula Lutea/*pathology
Macular Degeneration/etiology/pathology
Male
Postoperative Period
Prognosis
Retrospective Studies
Time Factors
Tomography, Optical Coherence
Visual Acuity

Figure

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  Fig. 1 The total and newly developed number of patients with macula edema after cataract surgery.

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  Fig. 2 The changes of central subfield macular thickness in eyes with and without prior laser treatment (A) and in eyes with and without macular edema (B) after cataract surgery. POD = postoperative day; ME = macular edema. *Student t-test (p < 0.05).

• 

  Fig. 3 The changes of best corrected visual acuity in eyes with and without prior laser treatment (A) and in eyes with and without macular edema (B) after cataract surgery. logMAR = logarithm of the minimal angle of resolution; ME = macular edema. *Student t-test (p < 0.05).

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