Macular edema after uncomplicated phacoemulsification in type 2 diabetics with NPDR

Abstract

Introduction:After uncomplicated cataract surgery, macular oedema has been suggested as the most common cause of visual deterioration and there is increased incidence of Macular Oedema (ME) in patients with diabetic retinopathy (DR). Further, ME has been seen to worsen after eye surgery in patients with pre-operative DME. Objective: To evaluate and compare the macular thickness changes after uncomplicated phacoemulsification in type 2 diabetes mellitus patients with Non Proliferative DR using Optical Coherence Tomography (OCT).Methods: The study was a hospital based prospective observational study conducted on 75 eyes of type 2 diabetes mellitus with NPDR who were diagnosed with cataract and underwent uncomplicated phacoemulsification. In all study subjects macular thickness using Cirrus High Definition (HD) OCT and Best Corrected Visual Acuity (BCVA) in Logarithm of Minimum Angle of Resolution (Log MAR) was recorded preoperatively and postoperatively at Day One, two weeks, four weeks, Six weeks and eight weeks to see changes in the macular thickness.Results: Out of 75 eyes macular edema was developed in 3 (4.0%) eye postoperatively. All central as well as parafoveal thickness increased significantly during our follow up time.Conclusion: Increase in central as well as parafoveal macular thickness was observed in subjects with NPDR after phacoemulsification. In few patients macular edema was also observed during our follow up period. OCT is a noninvasive, rapid, and useful tool in detecting and monitoring CME in post cataract surgery patients but longer follow up is needed to assess the risk of Cystoid macular edema (CSME) progression after cataract surgery and to see whether increase in central and parafoveal thickness after phacoemulsification is temporary or permanent.

Keywords: Non Proliferative Diabetic Retinopathy,Optical Coherence Tomography,Macular Oedema