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G.K. Escaravage, K.L. Cohen, S.B. Patel, M.E. Hartnett, B.B. Armstrong, C.M. Janowski; Quantitation of Perifoveal and Optic Disc Hyperfluorescence After Phaco and pcIOL in Patients With Diabetes Mellitus . Invest. Ophthalmol. Vis. Sci. 2005;46(13):772.
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Title: Quantitation of perifoveal and optic nerve hyperfluorescence after phacoemulsification and pcIOL in patients with diabetes mellitus Purpose: Examine relationships between surgical outcomes and changes in areas of hyperfluorescence (HF) in the perifoveal (PF) macula and optic nerve (ON) before and after phaco and pcIOL in diabetics. Methods: 30 eyes of 24 nonconsecutive diabetics had uncomplicated phaco and pcIOL under topical anesthesia. The fellow eyes served as the nonsurgical control group. Surgical (S) and nonsurgical (NS) eyes were evaluated concurrently before and 2 months after surgery. Variables included: best–corrected visual acuity (BCVA, ETDRS testing, recorded in LogMAR); quality of life (QOL, measured by VF–14); macular thickness (MT, Zeiss OCT–3); and areas of HF in PF and ON on digital fluorescein angiograms (WinStation 5000, Ophthalmic Imaging Systems (OIS) software, Sacramento, CA). Macular thickness (MT) was labeled as MT–1 (central 1 mm diameter), MT–2 (1 to 3 mm diameter, quadrants averaged), and MT–3 (3 to 6 mm diameter, quadrants averaged). Wilcoxon signed rank tests were used to determine differences between S and NS as well as between preop and postop results. Spearman correlations were computed. Results: S and NS eyes were evaluated 40 +/– 19 days preop (range, 1 to 68 days) and 52 +/– 8 days postop (range, 37 to 77 days). Mean preop NS HF were: PF 0.16367 and ON 0.11483. Mean preop S HF were: PF 0.13762 and ON 0.06409. There was no difference between preop S and NS HF for PF or ON. Mean postop NS HF were: PF 0.15069 and ON 0.05600. Mean postop S HF were: PF 0.30714 and ON 0.17107. There were significant differences between postop S and NS HF for PF (p=0.00037) and ON (p=0.00269). For S, HF for PF (p=0.00044) and ON (p=0.01892) increased postop, while for NS, HF for PF and ON were unchanged. For S, less improved QOL scores were associated with an increase in PF HF (p=0.0144), but not with ON HF. For S, less improved BCVA was associated with increased PF HF (p=0.0024), but not with ON HF. For S, increased MT–1 was associated with increased PF HF (p=0.0283) while increased MT–2 was associated with increased ON HF (p=0.00181). There was no association between changes in PF and ON HF for S or NS. Conclusions: In our study, phaco in diabetics improved BCVA and QOL, despite MT increases. Improved QOL was not dependent on BCVA. However, PF HF but not ON HF does affect BCVA and QOL. In the short term, PF leakage seems more important than MT. The importance of ON HF is questioned.
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