Central Foveal Thickness Before and After Cataract Surgery in Normal and in Diabetic Patients without Retinopathy

Abstract

Background: This study aims to evaluate and compare central foveal thickness (CFT) changes after cataract surgery between normal and diabetic patients without retinopathy, using optical coherence tomography (OCT).

Patients and Methods: Ninety-eight patients (49 patients with type 2 diabetes and 49 healthy controls, sex- and age-matched) undergoing phacoemulsification in one eye were included. The presence of retinopathy was an exclusion criterion. The OCT examination was performed preoperatively as well as one, three, six and twelve months postoperatively. CFT was evaluated and compared between groups.

Results: Preoperative CFT showed no significant difference between the two groups (normals: 205 ± 18 μm vs. diabetics: 202 ± 23 μm, p > 0.1). Postoperative CFT in diabetics at all time-points of the follow-up period was significantly increased when compared to controls (first month, normals: 215 ± 28 μm vs. diabetics: 262 ± 33 μm, p < 0.05; third month, normals: 211 ± 19 μm vs. diabetics: 250 ± 27 μm, p < 0.05; sixth month, normals: 208 ± 12 μm vs. diabetics: 266 ± 13 μm, p < 0.05; and twelfth month, normals: 209 ± 13 μm vs. diabetics: 280 ± 11 μm, p < 0.05). The incidence of cystoid macular edema (CME) was 4.0 % and 28.6 % for the control group and the diabetic group, respectively, at the end of the follow-up period (p < 0.05).

Conclusion: Eyes of diabetic patients without retinopathy present higher CFT and a higher incidence of CME after cataract surgery on OCT examination compared to eyes of healthy controls. This may explain the unsatisfactory visual acuity following cataract surgery in these patients.

Zusammenfassung

Hintergrund: Die Studie bewertet und vergleicht Veränderungen der zentralen fovealen Dicke (CFT) bei Normalpatienten und Diabetikern ohne Retinopathie mittels optischer Kohärenztomografie (OCT).

Patienten und Methoden: Eingeschlossen wurden 98 Patienten (49 Typ-2-Diabetiker und 49 gesunde Probanden, jeweils gematched nach Alter und Geschlecht), die sich einer einseitige Phakoemuslifikation unterzogen. Ausschlusskriterium war der Nachweis einer Retinopathie. OCT-Untersuchungen fanden vor bzw. 1, 3, 6 und 12 Monate nach dem Eingriff statt. Die CFT wurde zwischen beiden Gruppen ausgewertet und verglichen.

Ergebnisse: Die präoperative CFT zeigte keinen signifikanten Unterschied zwischen beiden Gruppen (Normale: 205 ± 18 μm vs. Diabetiker: 202 ± 23 μm; p > 0,1). Hingegen zeigte sich die CFT postoperativ bei den Diabetikern an allen postoperativen Untersuchungszeitpunkten vergleichsweise erhöht (Monat 1: Normale: 215 ± 28 μm vs. Diabetiker: 262 ± 33 μm, p < 0,05; Monat 3: 211 ± 19 μm vs. 250 ± 27 μm, p < 0,05; Monat 6: 208 ± 12 μm vs. 266 ± 13 μm, p < 0,05; Monat 12: 209 ± 13 μm vs. 280 ± 11 μm, p < 0,05). Die Inzidenz eines zystoiden Makulaödems (CME) betrug 4,0 % und 28,6 % bei der Kontrollgruppe bzw. der Diabetikergruppe am Ende des Beobachtungszeitraums (p < 0,05).

Schlussfolgerungen: Augen diabetischer Patienten ohne Retinopathie weisen im OCT eine erhöhte CFT und eine höhere CME-Inzidenz nach Kataraktoperation auf als die Augen einer gesunden Kontrollgruppe. Dies könnte die unbefriedigende Visusverbesserung nach dem Eingriff bei diesen Patienten erklären.

Key words

phacoemulsification - cystoid macular edema - diabetes mellitus - optical coherence tomography - fluorescein angiography - subclinical macular thickening

Schlüsselwörter

Phakoemulsifikation - zystoides Makualödem - Diabetes mellitus - optische Kohärenztomografie - Fluoreszeinangiografie - subklinische Zunahme der zentralen fovealen Dicke

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