Gupta Manisha¹* and Malviya Chetan²

¹Department of Ophthalmology, Shri Guru Ram Rai Medical Collage, Dehradun, Uttrakhand, India ²Department of Ophthalmology, Govt. District hospital, Baran of Sclerosis Diabetes Type 2, Rajasthan India

*Corresponding Author: Gupta Manisha, Department of Ophthalmology, Shri Guru Ram Rai Medical Collage, Dehradun, Uttrakhand, India.

Received: July 31, 2023; Published: October 20, 2023

Abstract

Introduction: Worldwide cataract is the major cause of preventable blindness, affecting 47.8% of patients worldwide. Cystoid macular edema (CME) after cataract surgery is a common complication and reported incidence of 0.1-2.35%. The major etiology is inflammatory mediators. SD-OCT is non-invasive, objective, quantitative tool with better resolution and reproducibility during follow-up visits. The aim of present study was to find out effect of phaco-parameters used in different grades of nuclear sclerosis.

Material and Method: Group 1 has 50 diabetic type 2 and group 2 has 61 non diabetic patients as control. The inclusion criteria was Grade NS2 to NS4 by LOCS III criteria,in group 1 patients with type 2 DM with no diabetic retinopathy and group 2 with no systemic disease, Age between 45yrs to 75. Exclusion criteria were systemic disease other than type 2 DM, complicatotted cataract, grade above NS4/belowNS2 by LOCS III, past History of ocular disease, surgery, laser, intravitreal injection, drugs and eventful cataract surgery. All subjects undergone detail ocular examination. Both group 1 and 2 were undergone for macular thickness with the help of Optical Coherence Tomography Pre and post operatively on day 01,07,30,60 and on 90th day. Macular thickness Analysis by taking macular cube scan of 9x9 squares centered on the fovea, the embedded 3D-OCT program used to calculate the thickness of the macula. Distance visual acuity on Snellen’s visual acuity chart, was converted to equivalent decimal value for simplification in statistical analysis.

Statistical Analysis: Statistical analysis was performed using the statistical package for social science system SPSS. Continuous variables values over time within the group were analyzed and presented as mean ± SD. Nominal categorical data between the groups were compared using the chi-square test and Fisher exact test as appropriate. P < 0.05 was considered statically significant.

Result: The mean central macular thickness in both groups preoperatively were 217.06 ± 17.27 μm in group 1 and 203.93 ± 12.87 μm in group 2. On postoperative day 7, central macular thickness in group 1 was 232.40 ± 16.56 μm; in group 2 was 218.67 ± 12.63 μm. On postoperative day 30 macular thickness in both groups increased subsequently 244.36 ± 18.75 μm and 224.13 ± 13.29 μm. Mean difference was found more in diabetic patients as compared to non diabetic from POD 7 and POD 30.This difference was 11.96 μm in diabetics while 5.46 μm in non-diabetics. On postoperative day 60, macular thickness in both groups subsequently decreased to 228.24 ± 16.85 μm and 214.3 ± 12.67 μm. The macular thickness on postoperative day 90 further decreased to 223.12 ± 18.48 μm in group 1 and 205 ± 12.32 μm in group 2. Mean of central macular thickness in patients with diabetes was significantly higher as compared to non-diabetics controls preoperatively as well as post-operatively and on each follow up and it is also statistically significant too.

Conclusions: The present study shows significant increase of macular thickness due to phaco energy in both groups. But increase of macular thickness doesn’t affect the visual acuity postoperatively

Keywords: Diabetes Mellitus; Cataract Surgery; Fundus Fluorescence Angiography (FFA)

References

1. Resnikoff S., et al. “Global data on visual impairment in the year 2002”. Bulletin of the World Health Organization 11 (2004): 844-851.
2. Klein BE., et al. “Incidence of cataract surgery in the Wisconsin Epidemiologic Study of diabetic Retinopathy”. American Journal of Ophthalmology3 (1995): 295-300.
3. Henderson BA., et al. “Clinical pseudophakic cystoid macular edema. Risk factors for development and duration after treatment”. Journal of Cataract Refractive Surgery9 (2007): 1550-1558.
4. Sneha Padidam., et al. “Prevalence of Cystoid Macular Edema After Cataract Surgery in Eyes with Previous Macular Surgery”. Clinical Ophthalmology 16 (2022): 423-427.
5. Sezen Akkaya and Yelda Ozkurt. “Changes in Central Macular Thickness after Uncomplicated Phacoemulsification Surgery in Diabetic and Non-Diabetic Patients”. Beyoglu Eye Journal1 (2018): 13-19.
6. Schmack I., et al. “Phthisi bulbi”. In: Levin L.A., Albert D.M., editors. Ocular Disease Mechanisms and Management. Saunders Elsevier; Maryland Heights, MO, USA (2010): 420. Chapter 54.
7. Joel M Perez., et al. “Association of Cumulative Dissipated Energy and Postoperative Foveal Thickness among Patients with Age-related Cataract who Underwent Uncomplicated Phacoemulsification”. Philippine journal of Ophthalmology 41 (2016): 50-55.
8. Anastasilakis K., et al. “Macular edema after uncomplicated cataract surgery: a role for phacoemulsification energy and vitreoretinal interface status”. European Journal of Ophthalmology3 (2013): 192-197.
9. Stunf Pukl S., et al. “Visual Acuity, Retinal Sensitivity, and Macular Thickness Changes in Diabetic Patients without Diabetic Retinopathy after Cataract Surgery”. Journal of Diabetes Research (2017): 3459156.

Citation

Citation: Gupta Manisha and Malviya Chetan. “Effect of Phaco Energy on Macular Thickness in Different Grade of Nuclear Sclerosis Diabetes Mellitus Type 2". Acta Scientific Ophthalmology 6.11 (2023): 16-22.

Copyright

Copyright: © 2023 Gupta Manisha and Malviya Chetan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.