Main Article Content
Abstract
BACKGROUND
This study was conducted to determine the incidence of cystoid macular edema after small incision cataract surgery by means of OCT, study the clinical profile and compare the incidence in non-diabetic and diabetic patients with and without retinopathy.
METHODS
This was a hospital based prospective study, conducted among 325 patients in the age group of 40 to 85 years who underwent Small Incision Cataract Surgery [SICS] conducted in Sree Mookambika Institute of Medical Sciences, Kulasekharam, Kanyakumary District, Tamil Nadu, over a period of one year from January 2022 to December 2023, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants.
RESULTS
The incidence of CME was higher among diabetic patients when compared with non-diabetic patients and was statistically significant. Patients with a history of uveitis had a statistically significant increase (p<0.05) in the incidence of CME in the 6th postoperative week. Patients with complicated surgery with iris prolapse, vitreous prolapse, difficult nucleus delivery and posterior capsular rent had an increased incidence of CME. This was statistically significant (p<0.05) during all three postoperative evaluations.
CONCLUSIONS
Following cataract surgery, 18.8% of patients developed cystoid macular edema six weeks after the procedure. Three months following surgery, 13.2% had CME, which further declined to 5.2% at six months after surgery. The incidence of clinically significant cystoid macular edema was 4% at six weeks after surgery. It further declined to 1.2% at 3 months after surgery and was present in only 0.6% at 6 months after surgery. The incidence of CME was higher among the diabetic patients throughout the study when compared with non-diabetic patients and was statistically significant (p<0.01). The association between the severity of diabetic retinopathy and the incidence of cystoid macular edema was not statistically significant. Patients with a history of uveitis had a statistically significant increase (p<0.05) in the incidence of CME in the 6th postoperative week. Patients with complicated surgery with iris prolapse, vitreous prolapse, difficult nucleus delivery and posterior capsular rent had an increased incidence of CME. Patients not using topical NSAIDS were found to have an increased incidence of CME.
Keywords
Article Details
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References
- Murthy GV, Gupta SK, Bachani D, et al. Current estimates of blindness in India. Br J Ophthalmol 2005;89(3)257-60.
- Hitchings RA, Chisholm IH, Bird AC. Aphakic macular edema: incidence and pathogenesis. Invest Ophthalmol 1975;14(1):68-72.
- Wright PL, Wilkinson CP, Balyeat HD, et al. Angiographic cystoids macular edema after posterior chamber lens implantation. Arch Ophthalmol 1988;106(6):740-4.
- Antcliff RJ, Stanford MR, Chauhan DS, et al. Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis. Ophthalmology 2000;107(3):593-9.
- Massin P, Erginay A, Haouchine B, et al. Retinal thickness in healthy and diabetic subjects measured using optical coherence tomography mapping software. Eur J Ophthalmol 2002;12(2):102-8.
- Gothwal D, Grover T, Grover A, et al. Incidence of cystoid macular oedema following manual SICS using. OCT AIOC 2009.
- Hee MR, Puliafito CA, Duker JS, et al. Topography of diabetic macular edema with optical coherence tomography. Ophthalmology 1998;105(2):360-70.
- Khandekar RB, Jain BK, Sudhan AK, et al. Visual acuity at 6 weeks after small incision cataract surgery and role of audit in predicting visual acuity. European Journal of Ophthalmology 2010;20(2):345-52.
- Eriksson U, Alm A, Bjärnhall G, et al. Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls. Graefe's Archive for Clinical and Experimental Ophthalmology 2011;249:349-59.
- Kwon SI, Hwang DJ, Seo JY, et al. Evaluation of changes of macular thickness in diabetic retinopathy after cataract surgery. Korean Journal of Ophthalmology 2011;25(4):238-42.
- Belair ML, Kim SJ, Thorne JE, et al. Incidence of cystoid macular edema after cataract surgery in patients with and without uveitis using optical coherence tomography. Am J Ophthalmol 2009;148(1):128-35.
References
Murthy GV, Gupta SK, Bachani D, et al. Current estimates of blindness in India. Br J Ophthalmol 2005;89(3)257-60.
Hitchings RA, Chisholm IH, Bird AC. Aphakic macular edema: incidence and pathogenesis. Invest Ophthalmol 1975;14(1):68-72.
Wright PL, Wilkinson CP, Balyeat HD, et al. Angiographic cystoids macular edema after posterior chamber lens implantation. Arch Ophthalmol 1988;106(6):740-4.
Antcliff RJ, Stanford MR, Chauhan DS, et al. Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis. Ophthalmology 2000;107(3):593-9.
Massin P, Erginay A, Haouchine B, et al. Retinal thickness in healthy and diabetic subjects measured using optical coherence tomography mapping software. Eur J Ophthalmol 2002;12(2):102-8.
Gothwal D, Grover T, Grover A, et al. Incidence of cystoid macular oedema following manual SICS using. OCT AIOC 2009.
Hee MR, Puliafito CA, Duker JS, et al. Topography of diabetic macular edema with optical coherence tomography. Ophthalmology 1998;105(2):360-70.
Khandekar RB, Jain BK, Sudhan AK, et al. Visual acuity at 6 weeks after small incision cataract surgery and role of audit in predicting visual acuity. European Journal of Ophthalmology 2010;20(2):345-52.
Eriksson U, Alm A, Bjärnhall G, et al. Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls. Graefe's Archive for Clinical and Experimental Ophthalmology 2011;249:349-59.
Kwon SI, Hwang DJ, Seo JY, et al. Evaluation of changes of macular thickness in diabetic retinopathy after cataract surgery. Korean Journal of Ophthalmology 2011;25(4):238-42.
Belair ML, Kim SJ, Thorne JE, et al. Incidence of cystoid macular edema after cataract surgery in patients with and without uveitis using optical coherence tomography. Am J Ophthalmol 2009;148(1):128-35.