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Cherrie-Ann M. Mattis, Marco Gonzalez, Ninel Z. Gregori; Visual Outcomes and Macular Status in Diabetic Patients after Cataract Surgery in a Teaching Institution. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6704.
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Diabetic Macular Edema (DME) is a leading cause of blindness in the United States. There is conflicting data as to whether or not cataract surgery influences the incidence or progression of macular edema in diabetic patients. The purpose of this study is to assess the effect of uncomplicated phacoemulsification with intraocular lens implantation on the incidence or progression of macular edema in diabetic patients operated on by resident/attending teams at the Miami Veteran’s Affairs Medical Center.
In a retrospective chart review covering January 2005 through July 2010, diabetic patients that had undergone uncomplicated phacoemulsification were identified. Patients were excluded if they had not undergone macular optical coherence topography (OCT) within three months of surgery. Best-corrected Snellen visual acuity (BCVA) and OCT central retinal thickness (CRT) were recorded before and after surgery.
Forty-one eyes in 37 patients were identified. The mean age was 68.9 years (SD=8.1, range 55 to 90). Forty patients were male. Sixteen eyes had pre-existing non-proliferative diabetic retinopathy and six eyes had proliferative diabetic retinopathy. The mean follow up after cataract surgery was 6.5 months (range 1 to 12 months). Median BCVA improved from 20/50 prior to surgery to 20/25 at month 1 (p<0.001, paired Wilcoxon) and 20/30 at month 6 (p=0.060, paired Wilcoxon). Mean CRT increased from 259.1(±62.7) to 307.7 microns (±93.9, P=0.22 t-test) at 1 month and to 294.9 (±103.5, P=0.38 t-test) at 6 months after cataract surgery. OCT measurement changes were not statistically significant across different post-op periods. Patients with diabetic macular edema on OCT prior to cataract surgery had stable OCT measurements post-operatively.
In this pilot study, uncomplicated cataract surgery performed by resident/attending teams led to a significant improvement in visual acuity while the OCTs remained stable regardless of pre-operative macular status.
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