Effect of Uncomplicated Cataract Surgery Shows No Significant Difference in CMT for Subjects With, Without Diabetes

No statistically significant difference in central macular thickness (CMT) between patients with and without diabetes was found preoperatively and in the early postoperative period after uncomplicated phacoemulsification surgery, according to study results published in the Journal of Ophthalmic and Vision Research.

Cataract extraction is among the most commonly performed ophthalmic surgeries, with the current preferred technique serving as phacoemulsification using small incisions and implantation of a foldable intraocular lens (IOL). While normally an efficient, uneventful surgery is associated with good visual results, the development of cystoid macular edema (CME) has occurred in patients with ocular diseases such as uveitis or diabetic retinopathy, even after uncomplicated cataract surgery.

As diabetes increases the probability of developing cataract and the risk of CME, researchers sought to examine the quantitative changes of macula in the eyes of diabetic and nondiabetic patients after cataract surgery. Researchers conducted a prospective interventional study in the early postoperative course of 6 weeks in patients with and without diabetes after uncomplicated phacoemulsification surgery with intracapsular IOL implantation.

• The study examined 660 eyes from patients planned for phacoemulsification with foldable IOL implantation who were either healthy (group 1; n = 330) or had well-controlled diabetes with no diabetic retinopathy (group 2; n = 330)
• Optical Coherence Tomography (Heidelberg Spectralis SD-OCT) was used to assess preoperative and postoperative CMT at weeks 1 and 6

Study results showed that preoperatively, mean (SD) CMT for group 1 was shown as 257.03 (20.904) mcm, compared with group 2’s mean (SD) CMT of 255.36 (17.852) mcm. The insignificant difference in mean (SD) CMT values between the 2 groups was additionally seen at postoperative week 1 (group 1, 262.82 [17.010] mcm; group 2, 259.15 [6.644] mcm; P = .374) and at postoperative week 6 (group 1, 265.15 [20.078] mcm; group 2, 266.09 [18.844] mcm; P = .313).

For all 3 occasions in which CMT was measured, no significant difference in mean CMT between the 2 groups was observed. As study participants had well-controlled diabetes without diabetic retinopathy, the study authors highlighted the potential relation to CMT measurements. “It is postulated that good diabetes control is needed to prevent an increase in CMT and postoperative macular edema after uncomplicated uneventful phacoemulsification procedure,” said the study authors.

Researchers noted that long term follow-up studies may be warranted to formulate management algorithms needed to dictate surgical paradigms.

Reference

Guliani BP, Agarwal I, Naik MP. Effect of uncomplicated cataract surgery on central macular thickness in diabetic and non-diabetic subjects. J Ophthalmic Vis Res. 2019;14(4):442-447.