A PROSPECTIVE STUDY ON THE COMPARISON OF MACULAR THICKNESS BETWEEN DIABETICS AND NON-DIABETICS FOLLOWING A SUCCESSFUL CATARACT OPERATION.

Sarika Ratha; Shovna Dash; Soumya Kanta  Mohanty; Lalitha C.S

doi:10.51168/sjhrafrica.v4i12.961

Authors

Sarika Ratha 3rd Year Ophthalmology Resident, Department of Ophthalmology, Kalinga Institute of Medical Sciences and Pradyumna Bal Memorial Hospital, KIIT University, Bhubaneswar, Odisha, India.
Shovna Dash Associate Professor, Department of Ophthalmology, Kalinga Institute of Medical Sciences and Pradyumna Bal Memorial Hospital, Bhubaneswar, Odisha, India.
Soumya Kanta Mohanty Associate Professor, Department of Ophthalmology, Kalinga Institute of Medical Sciences and Pradyumna Bal Memorial Hospital, KIIT University, Bhubaneswar, Odisha, India.
Lalitha C.S Assistant Professor, Department of Ophthalmology, Kalinga Institute of Medical Sciences and Pradyumna Bal Memorial Hospital, KIIT University, Bhubaneswar, Odisha, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v4i12.961

Keywords:

Cataract surgery, Diabetic macular edema, Optical Coherence Tomography, Post-operative complications

Abstract

Objectives

The study aims to note optical tomographic features in the macula post-cataract surgery among diabetic patients, with or without pre-existing macular edema. Additionally, it seeks to assess the incidence of macular edema and changes in macular thickness in diabetic and non-diabetic (control) patients after cataract surgery.

Methods

This prospective study, spanning May 2022 to August 2023, investigated 139 individuals (Group-A: diabetics with pre-existing macular edema, Group-B: diabetics without macular edema, Group-C: non-diabetic controls) undergoing cataract surgery. Standardized surgical procedures, postoperative care, and Spectral domain- optical coherence tomography (SD-OCT) scans were utilized. Repeated Measures ANOVA assessed macular edema progression and visual outcomes.

Results

The study included 139 individuals (101 diabetic, 38 non-diabetic) undergoing cataract surgery. Diabetic patients with macular edema (ME) had higher baseline BCVA, and ME severity varied. Repeated Measures ANOVA revealed a significant BCVA change over four weeks (p=0.001). CSMT increased significantly post-surgery (p=0.001). Diabetic ME patients exhibited higher BCVA and CSMT than controls. Postoperative changes included foveal dip elevation, cystoid changes, and increased hyperreflective foci, more pronounced in diabetics. ME development post-surgery was significantly higher in diabetics without ME (21.5%) compared to controls (5.26%).

Conclusion

The study underscores the heightened susceptibility of diabetic individuals to post-cataract macular edema and worsening of pre-existing macular edema, suggesting SD-OCT as a suitable non-invasive tool to differentiate ME attributed to diabetes and PCME.

Recommendation

The study recommends meticulous pre-operative glycemic control for diabetic patients and routine screening for macular edema. Implementing timely interventions and considering surgery delays in cases of detected macular edema are crucial to optimize post-operative visual outcomes.