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S.H. Khan, K.L. Cohen; Prevalence of and Risk Factors for Increased Macular Thickness after Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2004;45(13):281.
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Purpose: To determine (1) the prevalence of increased macular thickness in patients after routine uncomplicated phacoemulsification and (2) identify potential preoperative risk factors associated with increased macular thickness in surgical eyes after uncomplicated cataract surgery. Methods: Thirty–five non–consecutive patients scheduled for routine phacoemulsification and posterior chamber IOL were recruited. Surgical and nonsurgical eyes had macular thickness measured with the retinal thickness analyzer (RTA, Talia Technologies, Ltd., Neve Ilan, Israel) at one and six weeks after surgery. Surgical eyes with increased macular thickness at either time interval were evaluated retrospectively for the presence of specific preoperative factors and Fisher's Exact Test and Chi Square Test with Bonferoni correction were used to determine statistical significance. Results: The prevalence of increased macular thickness at any macular index after cataract surgery was 40.0% in surgical eyes versus 26.4% in nonsurgical eyes at one week and 34.2% versus 40.0% at six weeks. These differences were not found to be statistically significant however. The prevalence of increased thickness was increased in surgical eyes versus nonsurgical eyes at each macular index at one week (PP 31.7% vs 11.7%, PF 25.7% vs 8.5%, and F 40.6% vs 26.4%). At six weeks, these differences were not as dramatic. Additionally, the prevalence of increased thickness in surgical eyes decreased at each macular index from one to six weeks except at the foveal area (PP 31.4% to 14.2%, PF 25,7% to 8.5%, and F 40.0 to 34.2%) suggesting that increased macular thickness may be slower to resolve at the fovea. Associated risk factors (P–value ranging from 0.01 to 0.10) for increased macular thickness (any macular index) at one or six weeks included history of allergies, congestive heart failure, or stroke, use of multivitamins, antihistamines, diuretics, or ACE inhibitors, and presence of current or prior smoking history. None of these factors achieved statistical significance (P<0.001) however. Conclusions: Increased macular thickness occurs after uncomplicated phacoemulsification in the surgical eye at a greater rate than the nonsurgical eye at one week but this trend disappears at six weeks postoperatively. Potential risk factors for increased thickness after uncomplicated phacoemulsification include history of allergies, congestive heart failure, stroke, use of multivitamins, antihistamines, diuretics, ACE inhibitors, and presence of current or prior smoking history and warrant further investigation.
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