Incidence of macular edema and its related factors after cataract surgery in diabetics with and without diabetic retinopathy
Gao Shasha
,
Qin Tingyu
,
Zhao Lin
Department of Ophthalmology, Peking University Third Hospital, Peking University Eye Center, Beijing 100191, China (Gao Shasha and Qin Tingyu now working at the Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Eye Hospital)
Objective
To observe and analyze the incidence of macular edema and its related factors after cataract surgery in diabetics with and without diabetic retinopathy.
Methods
A retrospective study. The data of 90 diabetics including 45 cases with diabetic retinopathy (DR group) and 45 cases without DR (diabetics group) and an equal number of non-diabetic matched controls (control group) who underwent phacoemulcification and intraocular lens implantation were collected. Patients with macular edema before the surgery were excluded. Main outcome measurements included best-corrected visual acuity (BCVA) and central subfield mean thickness (CSMT). Optical coherence tomography (OCT) was used to measure the distance from the inner limiting membrane to the pigment epithelium of the central macular with diameter of 1 mm, which was used as the CSMT. There were no significant differences in BCVA and CSMT among three groups preoperatively (F=1.300, 1.329; P=0.280, 0.273). The BCVA and CSMT before and after the surgery in all three groups were compared. macular edema was defined as an increase of CSMT on OCT >30% from preoperative baseline. The incidence of macular edema of three groups after the surgery were compared and analyzed. The correlation between postoperative BCVA and CSMT, and the correlation between diabetes mellitus, DR and macular edema after surgery were analyzed by Logistic regression analysis.
Results
After the surgery, compared with control and diabetics group, the BCVA in DR group decreased and the CSMT increased significantly and the differences were statistically significant (P<0.05). However, between control and diabetics group, the differences in BCVA and CSMT after the surgery were not statistically significant (P>0.05). The incidences of macular edema in DR group (15.6% and 13.3%) 1 month and 3 months postoperatively were significantly more than that in control group (2.2% and 2.2%) and non-DR diabetics group (4.4% and 2.2%), and the differences were statistically significant (χ2=6.696, 6.644; P=0.035, 0.036). Logistic regression analysis showed that the postoperative BCVA was correlated with CSMT (r=0.444, P=0.000), diabetics was not correlated with postoperative macular edema (r=7.231, P=0.999) and DR was correlated with macular edema after surgery (r=0.378, P=0.008). The diabetic retinopathy might correlated to macular edema after surgery.
Conclusions
The incidence of macular edema after cataract surgery in patients with DR was significantly higher than that in patients without DR. There is no correlation between diabetics and postoperative macular edema, and DR is correlated with macular edema after surgery.
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