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Yulia Wolfson, Walter Stark, Susan Bressler, Neil Bressler; Short-term Spectral Domain Optical Coherence Tomography Changes after Phacoemulsification in Eyes with No Pre-operative Macular Pathology. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5924.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate short-term changes in macular retinal thickness following cataract surgery in eyes with no pre-operative macular pathology clinically across 3 different spectral domain optical coherence tomography (SD-OCT) devices.
With IRB approval, a consecutive, convenient cohort of patients scheduled for cataract surgery (89 patients, 101 eyes) with no clinical macular pathology were enrolled prospectively. Predisposing conditions for the post-surgical macular edema, such as diabetes or uveitis, were not exclusion criteria if the pre-op clinical exam of the macula was normal. SD-OCT macular scans on Optovue and either Cirrus or Spectralis SD-OCT devices were performed approximately 15 days pre- and 1-2 months post-op.
Among 92 eyes completing the study, mean central subfield thickness (CST) increased 11, 13 and 9 microns, respectively, from the pre- to post-op visit for Optovue, Cirrus, and Spectralis OCTs, respectively. 6 eyes (7.7%), 4 eyes (10.2%), and 2 eyes (4.5%) experienced at least a 10% increase in the CST using Optovue, Cirrus, and Spectralis scans, respectively. A 3% or greater increase in macular volume was observed in 36%, 51%, and 47% of eyes evaluated by Optovue, Cirrus, and Spectralis OCTs, respectively. One case of post-surgical clinical CME, as diagnosed by the cataract surgeon, was identified among the 92 eyes at day 40.
In the short-term following cataract surgery in eyes with no pre-operative macular pathology, mild macular retinal thickening can be expected, as demonstrated in this study by 3 different SD-OCT devices. Although central retinal thickening is not likely to be clinically relevant in most cases, the integrated change in thickness across all 9 ETDRS subfields, expressed as an increase in the macular volume, can be expected in about half of the eyes. These findings extend previous results using time-domain OCT and provide data which can be considered when evaluating short-term changes in eyes with pre-operative pathology, such as diabetic macular edema, as the findings in this study likely represent the expected distribution of short-term change in retinal thickness and volume following cataract surgery in a population of eyes without pre-operative macular pathology.
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