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Lei Cai, Jin Yang, zhongcui sun, Hongfei Ye, Yi Lu, ; Clinical implications of the changes in macular sensitivity and foveal thickness after phacoemulsification in cataract patients with diabetes. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):673.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the changes in Optical coherence tomography (OCT), microperimetry (MP), and visual acuity (VA) of a large series of diabetic patients after phacoemulsification and to evaluate its clinical implications.
A total of 1002 cataract patients with diabetes mellitus (DM) were recruited. OCT and microperimetry testing were performed within 4 weeks before surgery and at postoperative week 1, and month 1, 3. Best-corrected visual acuity (BCVA) in Log MAR was recorded. Pseudophakic cystoid macular edema (PCME) was deﬁned as an increase of center point thickness on OCT 30% from preoperative baseline, as well as a decrease (≥2dB) of the macular sensitivity (MS).
1002 eyes completed 3-month follow-up, of which 521 participants (521 eyes) had a diabetes mellitus (DM) duration of ≥ 5 years, while 481 participants (481 eyes) had a DM duration of less than 5 years. Based on the diagnosis standard (an increase in FT by 30%), 47 patients were diagnosed as PCME (an incidence of 4.69%). Of the 47 PCME patients, 38 patients had a DM duration of ≥ 5 years, a contrast to 9 patients who had a DM duration of less than 5 years. The incidence of PCME was significantly greater in patients of ≥ 5 years DM duration than in patients of < 5years DM duration (odds ratio [OR] = 4.5821, 95% CI, 2.2394 - 9.3755; p = 0.022[ZZ1] ) In the PCME patients, FT is significantly thicker at 1-month follow-up than that at 1-week follow-up, and MS is significantly lower at postoperative 1 month than that at postoperative 1 week, both of which returned to the 1-week levels by 3 months. Of the 47 PCME patients, 20 patients were simultaneously with a decrease of MS (≥2dB) (OCT plus MP examination) while 8 patients had a decrease of BCVA (≥ 2 lines) (OCT plus BCVA). A significant difference was found between the two methods designed for evaluating the macular function.
Individuals with a long duration of diabetes are predisposed to PCME after uneventful phacoemulsification; the combination of OCT and MS can act as an effective method to evaluate the macular function after phacoemulsification for the cataract patients with diabetes.
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