Macular Thickness Changes After Cataract Surgery in Non Glaucoma Patients versus Glaucoma Patients on Topical Hypotensive Lipids

Abstract

Purpose: : To compare macular thickness after cataract surgery in patients with glaucoma on topical hypotensive lipids and patients without glaucoma .

Methods: : This was a retrospective study that analyzed 112 eyes that had undergone cataract surgery by phacoemulsification with posterior chamber intra-ocular lens placement (CE). Macular thickness was measured using Optical Coherance Scans(Zeiss Stratus OCT ©) within one year prior to CE for a pre-operative value and within one year following CE for a post-operative value. The foveal area(F) was designated as 0-1mm radius from the center of the macula. The peri-foveal (PF) area was assigned 1-3mm radius 3-5mm from the center. The eyes were divided into 2 groups; eyes without glaucoma and eyes with glaucoma on hypotensive lipids. Data was analyzed using paired t-tests and unpaired t-tests.

Results: : 48 eyes were in the without glaucoma group(WGL)and 54 eyes were in the glaucoma group(GL). The WGL represented by 15men and 33women, made up of 38 African American, 9 Caucasian and 1 Hispanic patient. The average age was 69.8 ± 9.7 (range 43-86) years. The glaucoma group was represented by 24 men and 30 women, made up of 47 African American, 5 Caucasian and 2 Asian patients. The average age was 71.6.8 ± 8.8 (range 43-86) years. The pre-operative (pre-op) average for the F region in the WGL group was 222.6 ± 11.6 µm and 195.7 ± 8.0µm in the GL group. The post-operative (post-op) average in the F region in the WGL was 243.3 ± 13.7µm and in GL group 199.9 ± 7.3. There was no significant change between the pre-op and post-op means of the fovea of WGL eyes (P=0.15). There was no change between the pre-op and post-op means of the fovea of GL eyes (P=0.38). In this region we can suggest that the difference in thickness between pre-op and post-op is greater in the WGL group than in the GL group(t0=2.16, P=0.03). The pre-op average for the PF region in the WGL group was 255.8 ± 7.16 µm and 251.9.7 ± 5.4µm in GL group. The post-op average in the PF region in the WGL group was 276.9 ± 10.2µm and in GL group 263.6 ± 8.2. There was change between the pre-op and post-op means of the PF of WGL eyes (P=0.03). There was also change between the pre-op and post-op means of the PF group of GL eyes (P=0.01). In this region, the difference in thickness between the pre-op and post-op in the WGL and GL was the same (t0=1.47, P=0.07).

Conclusions: : There was no difference in macular thickening measured by OCT following CE between patients without glaucoma and those with glaucoma on hypotensive lipids.

Keywords: edema • macula/fovea • treatment outcomes of cataract surgery