The incidence of cystoid macular edema in patients with or without diabetes after uncomplicated phacoemulsification: A four-year study

Abstract:

AIM: To report the incidence of post-operative cystoid macular edema(pCME)in patients with or without diabetes and its correlation with cumulative dissipated energy(CDE)and phaco-time after uncomplicated phacoemulsification.

METHODS: In the study 116 nondiabetic(Group A)and 101 diabetic patients(Group B)underwent phacoemulsification. Preoperatively none of the groups(A+B)had signs of maculopathy or diabetic macular edema documented by spectral-domain optical coherence tomography(SD-OCT)and fundus fluorescein angiography(FFA). Phaco metrics were documented after surgery. FFA was performed two months after each operation. Patients with indications of pCME were reassessed with SD-OCT.

RESULTS: The incidence of pCME after uncomplicated phacoemulsification was statistically significant difference between the two groups(15.8% in Group B versus 6.9% in Group A, P=0.03<0.05). The subclinical pCME appeared in 19 out of 24 patients. There was a significant correlation between parametric values(CDE, phaco-time, hardness of the lens)and pCME occurrence. Glycosylated Hemoglobin(HbA1c)blood levels was statistically significant difference(P=0.005<0.05)between the patients who developed or not pCME. Cystoid macular edema did not correlate with the axial length of the eye.

CONCLUSION: There was statistically significant difference in the incidence of pCME after uneventful phacoemulsification between nondiabetic subjects and diabetics. Most of these patients with pCME had subclinical appearance. CDE and phaco-time data were important factors and predictors to pCME. Good glycemic controls prevent the incidence of pCME.

Key words:cataract; cystoid macular edema; cumulative dissipated energy; phacoemulsification; HbA1c