Macular Changes after Uneventful Phacoemulsification in Diabetic Patients in a Tertiary Hospital (original) (raw)
Related papers
2022
Objective: To compare OCT changes on macular thickness after uneventful phacoemulsification in diabetic and non-diabetic patients. Methodology: A prospective comparative study was conducted at Shaheed Mohtarma Benzair Bhutto Medical College Lyari and Sindh Government, Lyari General Hospital Lyari Karachi consisting of 30 patients that were to undergo phacoemulsification surgery and subsequent intraocular lens implantation (IOL) procedure. They were divided into three equal groups, first groups was the control groups without diabetes, second group consisted of patients with confirmed diabetes mellitus with no diabetic retinopathy and the third group was with diabetes mellitus as well as diabetic retinopathy (DR). Preoperative macular thickness and visual acuity was assessed of all the patients. After the successful completion of the surgery macular thickness using OCT and BCVA was assessed once again after 1 st week, 1 st month, and 6 th month. Data was analyzed using SPSS Version 20.0 and comparison among groups was done using independent ttest, with P-value set at ≤0.05 to be considered as significantly different. Results: In total 30 patients participated in the study. 18(60%) were male and 12(40%) were female patients in the study. The mean age of the participants in the study was 58.43±8.74.Increase in macular thickness was seen in all groups but it was less in the control group and diabetic group without DR, however macular thickness remained high in the group with DR. BCVA improved in all groups but least improvement was seen in the group with DR. No Medicine Volume 50, Issue 1, January 2022, 3 significant difference was observed in the macular thickness when comparing groups preoperatively (P=0.082) and during the 1 st week (P=0.122). Significant difference was observed in the macular thickness when comparing groups one month (P=0.018) and six month (P=0.002) post-operatively. No significant difference was observed in the BCVA when comparing groups pre-operatively (P=0.021) and during the 1 st week (P=0.016). Significant difference was observed in the BCVA when comparing groups one month (P=0.007) and six month (P<0.001) postoperatively. Conclusion: Diabetic Retinopathy among Diabetics affects the macular thickness on OCT following uneventful phacoemulsification
Egyptian Journal of Medical Research, 2022
Background: Phacoemulsification (phaco) is one of the most widely used cataract surgery techniques nowadays. Various factors can influence the tissue structures of the eyeball eg. Ultrasonic energy, fluidics, mechanical effects, compression, and hypoxia on the tissue. Every step of this maneuver can cause direct or indirect effects on ocular tissues. Ultrasonic energy and fluidics produce mechanical effects that cause an inflammatory reaction which affects cornea, retina and choroid. Objective: To evaluate the effect of phacoemulsification on retina to compare these effects in diabetic and non-diabetic patient to reach a conclusion whether diabetic patient are more vulnerable to these effects or not. Patients and Methods: This is a prospective cohort observational study that included 100 eyes of 100 patients (50 diabetic patients (Type II), 50 non diabetic patients) having immature senile cataract. Patients were recruited from the ophthalmology department of Beni-Suef University. Re...
A Correlation of Glycemic Index and Macular Thickness After Phacoemulsification in Diabetics
Delhi Journal of Ophthalmology, 2019
Purpose: To study the relationship between HbA1c and macular thickness using Optical coherence tomography (OCT). Methods: Prospective cohort study where 50 eyes of type 2 Diabetes mellitus patients with mild to moderate Non-Proliferative Diabetic Retinopathy (NPDR) were included. They underwent uncomplicated phacoemulsification surgery and were divided into 3 groups based on HbA1c levels-Group 1: <6.5%, Group 2: 6.5%-8% and group 3: >8%. Nine macular subfields as defined by Early Treatment of Diabetic Retinopathy study (ETDRS) were measured using OCT. The HbA1c level of each patient was measured and compared with the macular thickness as well as visual acuity. Result: No correlation of HbA1c level and central foveal thickness was found in our study (p=0.554). The change in visual acuity also had no correlation with HbA1c (p>0.05). There was a significant increase in central foveal thickness at 1 month postoperatively, irrespective of HbA1c level (p=0.002, p=0.001, p=0.005). Conclusion: HbA1c has no impact on central foveal thickness or BCVA. Diabetics undergoing phacoemulsification show a change in central foveal thickness post operative but that may not necessarily be due to uncontrolled diabetes.
NILES journal for Geriatric and Gerontology, 2020
Background: Corneal thickness is a sensitive indicator of the health of the cornea and serves as an index for corneal hydration and metabolism. It is an important indicator of patency of the corneal endothelial pump. Corneal endothelial damage following phacoemulsification is still one of the major concerns of modern day cataract surgery. Although many techniques have been proposed, the risks of posterior capsular rupture and corneal endothelium damage persist. Aim of the Work: This study was designed to assess the effect of phacoemulsification on central corneal thickness measured by anterior segment OCT in non-diabetic and diabetic patients. Methods: Our study included 20 cases subdivided into 2 groups: 10 cases normal (nondiabetic) and 10 cases diabetic without retinopathy ranged from 18 to 60 years, with a mean age of 56.50 years in the non-diabetic group and 55.70 years in the diabetic without retinopathy group. SD in non-diabetic group ± 2.22, in the diabetic without retinopathy group ±3.13, p = 0.518, in the normal non-diabetic group 7 cases (70.0 %) were men and 3 cases (30.0%) were women. In the diabetic without retinopathy group, 6 cases (60.0%) were men and 4 cases (40.0%) were women. In the non-diabetic group, the mean average CCT was 500.80 ± 23.73μm before phaco, 508.90 ± 28.33μm 0ne week after phaco with P = 0.021 and 501.10 ± 24.33μm one month after phaco with P = 0.011. In the diabetic without retinopathy group, the mean average CCT was 508.50 ±6.75μm before phaco ,535.20 ±16.98μm one week after phaco with P = 0.021 and 527.60 ±16.63 μm one month after phaco with P = 0.011. Results: There was found a significant change in CCT after phacoemulsification in both diabetic and non-diabetic groups, and the eyes of patients with diabetes mellitus showed a delay in the postoperative recovery of corneal edema compared with non-diabetic eyes. Conclusion: Patients with diabetes have significantly more endothelial damage and more corneal edema in comparison to non-diabetic controls with similar nuclear grading and phaco energy used.
The Egyptian Journal of Hospital Medicine, 2018
Aim of the Study: was to investigate the influence of phacoemulsification on corneal endothelial cells and its injury risk factors in diabetic cataract patients and non-diabetic patients. Methods: electronic databases were searched: Scopus, EMBASE, and Google Scholer), PubMed/MEDLINE, Scopus, The Cochrane Library, and Web of Science. Econlit from 1990 to 2017. This was completed with a manual search of references of relevant papers. Risk of bias in methodology of studies was measured using the Newcastle-Ottawa Scale. Results: Observation of corneal endothelial cell density, coefficient of variation and percentage of hexagonal cells preoperatively, 1 day, 1week, 1 and 3 months postoperatively was carried out, and multiple Logistic regression analysis for risk factors of corneal endothelial cell injury was taken. Results: Out of 779 retrieved papers, 9 studies with a total of 1129 individuals were finally included (579 diabetic eyes and 550 non-diabetic eyes). For the dynamic changes between preoperative and postoperative values, significant differences were identified between the two groups in endothelial cell density (ECD) and hexagon cells (HC%) at 1 day, 1 week, 1 month, and 3 months postoperatively, in central corneal thickness (CCT) at 1 month postoperatively, and in coefficient variation (CV) at 1 week and 1 month postoperatively. However, no significant differences were observed in CCT at 1 day, 1 week and 3 months postoperatively or in CV at 1 day and 3 months postoperatively. Conclusion: it could be concluded from the current literature that aged-cataract patients with diabetes mellitus manifested poor tolerability to cataract phacoemulsification surgery in contrast to senile cataract patients.
Reviews in Clinical Medicine, 2020
Introduction This study aimed to investigate the effect of phacoemulsification on macular thickness and volume in diabetic patients without retinopathy using optical coherence tomography (OCT).Methods This prospective study included 37 diabetics and 55 non-diabetic patients (n=92) with cataract who were scheduled for phacoemulsification. The participants were entered into the study based on the inclusion and exclusion criteria following a complete eye examination. Macular thickness and volume were measured preoperatively as well as one month postoperatively using the OCT (Spectralis; Heidelberg Engineering, Heidelberg, Germany).Results The present study analyzed 76 eyes of 76 patients with immature cataract. No significant differences were observed between diabetic and non-diabetic groups in terms of thickness and volume in the macular area. However, the results showed a significant increase in both groups regarding the thickness and volume after phacoemulsification. Conclusion The ...
The Egyptian Journal of Hospital Medicine, 2019
Introduction: Cataract surgery by phacoemulsification is an invasive procedure that has become the most common intraocular surgery and usually improves the visual outcome. However, it is an inflammatory process to the eye and in many cases can lead to worsening of pre-existing retinal diseases such as diabetic macular edema or development of new diseases such as Irvine-Gass syndrome. This inflammatory response is mostly induced by the release of prostaglandins. Objective: The aim of this study was to evaluate the effect of uneventful phacoemulsification on the morphology and thickness of the macula and the choroid. Patients and Methods: In 30 eyes from 30 patients (15 non-diabetic and 15 diabetic), central retinal macular thickness, and subfoveal choroidal thickness, were measured preoperatively and one month and three months after phacoemulsification using optical coherence tomography. Results: In non-diabetic patients, central macular thickness was 202.80±22.39 μm before phaco and...
2020
Background: Corneal thickness is a sensitive indicator of the health of the cornea and serves as an index for corneal hydration and metabolism. It is an important indicator of patency of the corneal endothelial pump. Corneal endothelial damage following phacoemulsification is still one of the major concerns of modern day cataract surgery. Although many techniques have been proposed, the risks of posterior capsular rupture and corneal endothelium damage persist. Aim of the Work: This study was designed to assess the effect of phacoemulsification on central corneal thickness measured by anterior segment OCT in non-diabetic and diabetic patients. Methods: Our study included 20 cases subdivided into 2 groups: 10 cases normal (nondiabetic) and 10 cases diabetic without retinopathy ranged from 18 to 60 years, with a mean age of 56.50 years in the non-diabetic group and 55.70 years in the diabetic without retinopathy group. SD in nondiabetic group ± 2.22, in the diabetic without retinopath...
Retina-the Journal of Retinal and Vitreous Diseases, 2011
Purpose: To report visual results and anatomical outcome after uncomplicated phacoemulsification in eyes that previously underwent pars plana vitrectomy for diabetic macular edema. Methods: This retrospective noncomparative study included 22 eyes of 19 diabetic patients who underwent uncomplicated cataract surgery with phacoemulsification and intraocular lens implantation after pars plana vitrectomy with internal limiting membrane removal for diabetic macular edema. Main outcome measures included visual acuity and foveal thickness (FT) changes as assessed by optical coherence tomography. Wilcoxon test was used for statistical analysis. Results: Mean follow-up time was 11.9 6 8.75 months. Mean FT increased by 20.5 6 67.6 mm (8.4%), with a mean preoperative FT of 237 6 69 mm compared with a mean postoperative FT of 257.6 6 89.8 mm (P = 0.236). Foveal thickness increased by at least 20% in 6 eyes (27.3%), remained within 20% in 14 eyes (63.6%), and decreased by 20% in 2 eyes (9.1%). Visual acuity improved by $2 lines in 16 eyes (72.7%) and remained stable in 6 eyes (27.3%). Visual acuity was 20/40 or better in 11 eyes (50%). Conclusion: Moderate but insignificant increase in FT was observed after phacoemulsification in eyes that previously underwent pars plana vitrectomy for diabetic macular edema. Prospective studies with a large number of patients are warranted for a more reliable conclusion.