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M. Figus, M. Romagnoli, I. Appolloni, P. Fogagnolo, A. Canovetti, M. Nardi; Optical Coherence Tomography in Cataract Surgery in Diabetic Patients. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3490.
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to investigate the incidence of subclinical cystoid macular edema in diabetic patients after uncomplicated cataract surgery (phacoemulsification and IOL implant in the bag) by Optical Coherence Tomography (OCT).
a controlled clinical trial was performed. 33 subjects with Diabetes Mellitus (DM) without clinically significant macular edema (CSME) and without OCT changes in retinal thickness and morphology, and 63 subjects without DM (36 M, 27 F) undergoing cataract surgery underwent a complete ophthalmic evaluation (general and ophthalmic history, slit-lamp anterior segment biomicroscopy, Best Corrected Visual Acuity measurement, Goldmann applanation tonometry, fundus oculi biomicroscopy with +90 D lens), and OCT of the macular region after pharmacological mydriasis. These examinations were executed preoperative (baseline), 7-10 days postoperative (time 1), 20-30 days postop (time 2), 3 months postop (time 3). The changes in macular thickness (MT) and total macular volume (TV) were inspected by means of analysis of variance and between-visit t-test.
a significant difference in macular thickness between preoperative and postoperative wasn’t found during the follow-up neither in diabetic patients nor in non diabetics; on the contrary a significant increased total volume (TV) in diabetic patients was detected a week after the surgery (p=0.001), after a month and after 3 months (p=0.031). In non diabetic patients the TV variations found in the postoperative in non diabetic patients were non statistically significant.
This series confirm that, after uncomplicated cataract surgery, an increase in macular volume occurs in diabetic patients without CSME. This problem should be discussed with patients before obtaining the informed consent.
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