EFFECT OF UNCOMPLICATED ULTRASOUND PHACOEMULSIFICATION CATARACT SURGERY ON CENTRAL MACULAR THICKNESS CHANGES IN THE EARLY POSTOPERATIVE PERIOD IN DIABETIC PATIENTS

无并发症超声乳化白内障手术对糖尿病患者术后早期中心黄斑厚度变化的影响

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Abstract

The aim of this prospective study was to determine changes in central macular thickness in the early postoperative period after uncomplicated phacoemulsification cataract surgery in diabetic patients using spectral domain optical coherence tomography (SD-OCT). Uncomplicated ultrasound phacoemulsification cataract surgery causes minimal changes of retinal layer thickness, which may result in subclinical cystoid macular edema development. This prospective study included 55 patients divided into two groups. Group 1 included diabetic patients with cataract, and group 2 included patients with cataract and without diabetes. All patients underwent uncomplicated ultrasound phacoemulsification cataract surgery at the Department of Ophthalmology, University Hospital Osijek in the period from November 2017 to January 2018. Patients were followed-up for one month after surgery. At each examination, OCT recording of the eye undergoing cataract surgery was performed. A statistically significant difference in central macular thickness in the diabetic group and control group (p=0.0005 both) was confirmed preoperatively and one month after cataract surgery. A statistically significant difference in central macular thickness was confirmed in diabetic group (p=0.006), as well as in the control group of patients (p=0.01) seven days and one month after cataract surgery. There was no statistically significant difference in macular thickness changes between the diabetic and control group of patients preoperatively (p=0.618), seven days (p=0.6848) or one month after cataract surgery (p=1). The effect of HbA1c on macular thickness change in diabetic patients was not statistically significant. The mean HbA1c in diabetic patients was 7.24±1.34%. There was no statistically significant difference in the effect of cumulative dissipated energy on macular thickness change in either group. This study confirmed a statistically significant correlation of the effect of fluid volume consumption on macular thickness changes in diabetic patients. There was no statistically significant effect of fluid volume consumption on macular thickness change in the control group of patients. Uncomplicated ultrasound phacoemulsification cataract surgery caused changes in cen-tral macular thickness in the early postoperative period in both patient groups. Changes in central macular thickness in the observed period were not manifested with clinically significant macular edema or by a more significant decrease in visual acuity. All patients had significant improvement in visual acuity seven days and one month after cataract surgery.

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