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.

Keywords: OCT; diabetes mellitus; diabetic retinopathy; macular edema; macular thickness; phacoemulsification.

Figure 1

Temporal evolution of the mean macular thickness in the different ETDRS grid areas. The thickness measurements are expressed in microns. Abbreviations: CENTRAL is the central 1 mm ring; 3SUP, 3INF, 3NASAL, and 3TEMP are, respectively, the superior, inferior, nasal, and temporal quadrants of the 3 mm ring in the ETDRS grid; 6SUP, 6INF, 6NASAL, and 6TEMP are, respectively, the superior, inferior, nasal, and temporal quadrants of the 6 mm ring in the ETDRS grid; MV is the macular volume and AVERAGE is the average retinal thickness.

Figure 2

Mean values of the retinal thickness in the central area of the 1 mm diameter ring for DM patients and non-diabetic subjects during the follow-up time points. Values are expressed in microns.

Figure 3

Mean values of the retinal thicknesses in the 3 mm ring of the ETDRS macular grid for DM patients and non-diabetic subjects during the follow-up time points. Values are expressed in microns.

Figure 4

Mean values of the retinal thicknesses in the 6 mm ring of the ETDRS grid for DM patients and non-diabetic subjects during the follow-up time points. Values are expressed in microns.

Figure 5

Mean values of the retinal thicknesses in the central 1 mm ring of the ETDRS grid for DM patients and non-diabetic subjects grouped by gender during the follow-up time points. Values are expressed in microns.

Figure 6

Mean values of average retinal thickness for operated and control eyes during the follow-up time points. Values are expressed in microns.

Figure 7

Mean values of macular volume for operated and control eyes during the follow-up time points. Values are expressed in mm³.

Figure 8

Temporal evolution of mean best corrected visual acuity (BCVA).