International Journal For Multidisciplinary Research

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Study of Central Macular Thickness in Patients of Diabetes Mellitus Before and After Cataract Surgery

Author(s) Acid Dholakia, Sarita Aggarwal, Shikha Pawaiya, Somesh Ranjan
Country India
Abstract To study the changes in central macular thickness (CMT) in diabetic patients before and after cataract surgery using optical coherence tomography (OCT) and compare on the basis of grades of diabetic retinopathy (DR). Methods: This is a prospective observational, single centre hospital based study including 94 patients with diabetes mellitus undergoing phacoemulsification surgery at our hospital. The pre-op stage of DR, best corrected visual acuity (BCVA), CMT, glycosylated hemoglobin (HbA1c) levels were recorded and the data compared with post-op BCVA, CMT measured at one week, four weeks and three months post-op. ANOVA: Two factor without multiplication and Karl Pearson’s correlation coefficient were used for statistical analysis. Results: A total of 6.4% (6) patients developed post-operative clinically significant macular edema (CSME) out of which 9% had moderate non proliferative diabetic retinopathy (NPDR), 16.6% had severe and very severe NPDR. 58.5% (55) were found to have sub clinical macular edema (SCME) detected by OCT-macula, which includes 11 (45.8%) no DR cases; 14 (58.3% ) cases of mild NPDR; 14(63.63%) cases of moderate NPDR; 16 (66.67%) cases of severe and very severe NPDR (p=0.000133). The post-operative BCVA at week four, for patients with no DR; mild NPDR; moderate NPDR; severe and very severe NPDR is 20/25; 20/30; 20/40; 20/40 respectively showing lesser BCVA in patients with higher grades of diabetic retinopathy than those with mild NPDR or no DR. Among the patients who had either SCME or CSME post-operatively, it was found that 17 had pre-op SCME of which 4 had moderate NPDR and 13 had severe or very severe NPDR. The maximum rise in central macular thickness, was observed in patients with preoperative moderate, severe and very severe NPDR and those having pre-operative sub-clinical macular oedema. Among those developing CSME, 100% had uncontrolled blood sugar (UCBS) levels, and those with SCME, only 29.09% had controlled blood sugar (CBS) while rest 70.91% had UCBS. Discussion: It was found that those patients with an UCBS, pre-existing severe DR and SCME developed a significant increase in central macular thickness, following cataract surgery. It can be concluded that in diabetic patients the blood sugar levels and pre-operative stage of DR are important prognostic factors in determining post-operative macular thickness and visual recovery post cataract surgery.
Keywords Diabetic Retinopathy; Cataract surgery; Central macular thickness; Optical coherence tomography
Field Biology > Medical / Physiology
Published In Volume 7, Issue 1, January-February 2025
Published On 2025-02-20
Cite This Study of Central Macular Thickness in Patients of Diabetes Mellitus Before and After Cataract Surgery - Acid Dholakia, Sarita Aggarwal, Shikha Pawaiya, Somesh Ranjan - IJFMR Volume 7, Issue 1, January-February 2025. DOI 10.36948/ijfmr.2025.v07i01.37272
DOI https://doi.org/10.36948/ijfmr.2025.v07i01.37272
Short DOI https://doi.org/g85stj
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