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A.A. Khanifar, A. Chomsky, F.M. Recchia; Macular Thickness Following Phacoemulsification: An Optical Coherence Tomography Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4500.
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Cystoid macular edema (CME) is a significant source of morbidity following cataract surgery, though the increased use of phacoemulsification has decreased its incidence significantly compared to intracapsular or extracapsular non–phacoemulsification techniques. The incidence and time course of CME has been studied with fluorescein angiography. Optical coherence tomography (OCT) is an excellent tool for imaging the macula, however, macular edema in the setting of phacoemulsification has not been studied by this imaging modality. Our primary objective is to determine the change in macular thickness measured by OCT before and after phacoemulsification.
A prospective study of eyes undergoing cataract extraction by phacoemulsification was begun in October 2005. Eyes in which the density of the cataract precluded OCT scanning were excluded from the study. Macular thickness for the central 1.00 mm, eight macular subfields and total macular volume are measured using the OCT3 Fast Macular Thickness scanning protocol at the following timepoints: within 30 days pre–operatively , on postoperative day 1, at postoperative week 1, postoperative month 1, and postoperative month 3. Differences in macular thickness and volume are compared with the paired t–test. Clinical data recorded at these timepoints include: best–corrected visual acuity, phacoemulsification time, presence of intraoperative complication, presence of posterior vitreous detachment, and macular appearance.
In 5 eyes enrolled to date, the following mean and standard deviation values were calculated for the pre–operative and post–operative day 1 scans, respectively: central 1.00 mm thickness: 229.8 ± 20.4 µm and 217.0 ± 38.7 µm (p = 0.268), and total volume: 6.788 ± 0.448 µm3 and 6.491 ± 0.542 µm3 (p = 0.186). There were no statistically significant differences in any of the macular subfield thicknesses.
Preliminary results from a small cohort of this prospective, longitudinal study suggest no acute changes in macular thickness following phacoemulsification surgery. With ongoing data collection and analyses, stronger conclusions regarding the timing, incidence, and factors associated with CME can be made.
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