Choroidal thickness changes following cataract surgery in patients with type 2 diabetes mellitus

Abstract

Purpose To evaluate the choroidal thickness changes after cataract surgery in type 2 diabetic patients. Methods Three groups of patients were enrolled into this prospective study. Group A included diabetic patients without diabetic retinopathy (DR) or with mild non-proliferative diabetic retinopathy (NPDR) who underwent phacoemulsification, Group B included non-diabetic patients with significant cataract who underwent phacoemulsification, and Group C included diabetic patients without DR or with mild NPDR who followed up without surgical procedure. Choroidal thickness in 5 points (subfoveal and 500 μ temporal, nasal, superior and inferior to the fovea) and central macular thickness were measured before surgery using enhanced depth spectral domain optical coherence tomography. Patients were re-evaluated 1 week, 1 month, and 3 months after operation and compared with the baseline values. Results In total, 63 eyes from 63 patients were enrolled to this study, including 21 eyes in Group A, 22 eyes in Group B, and 20 eyes in Group C. After three months of follow-up of the patients, choroidal thickness in all measured points was decreased significantly, and central macular thickness was increased significantly following cataract surgery in diabetic eyes (Ggroup A); meanwhile, both choroidal thickness and central macular thickness were increased significantly in non-diabetic eyes (Group B). In Group C, choroidal thickness and central macular thickness had no significant changes, after three months. Conclusion Unlike in non-diabetic eyes, choroidal thickness in diabetic patients decreased following cataract surgery.

Effects of Femtosecond Laser-Assisted Cataract Surgery on Macular and Choroidal Thickness in Diabetic Patients

“…The choroid has the role of providing nutrition and oxygenation to the retinal pigment epithelium layer and the outer retina layer. The dysfunctional choroid also affects the retinal function and plays an important role in the development of DR [ 17 ]. Therefore, the use the retina and choroid parameters to observe fundus changes in diabetic patients after cataract surgery is more comprehensive.…”

“…Ibrahim et al [ 54 ], using EDI-OCT, found that SFCT was significantly increased 1 week after PE and returned to the preoperative level at month 3 after surgery. However, conflicting results have been reported in studies on postoperative SFCT changes in diabetic patients, with some studies showing that SFCT increased after PE surgery in diabetic patients [ 55 , 56 ], while others have found no change [ 57 , 58 ], and yet others have shown a postoperative reduction in choroidal thickness [ 17 ]. In the present study, the SFCT increased at week 1 after surgery in the PE group and began to decline at month 3, but did not return to preoperative levels until month 12.…”

“…Simultaneously, the heat, radiation and shock generated by PE have a greater influence on the vitreous and fundus [ 12 , 13 ]. After the operation, some diabetic patients have an accelerated course of fundus microangiopathy [ 14 ], retinal thickening [ 15 ] and choroidal thickening, with different changes shown among studies [ 16 , 17 ]. Researchers have confirmed that femtosecond laser-assisted cataract surgery (FLACS) can optimize PE parameters [ 18 ], reduce the cumulative release of ultrasound energy [ 19 ] and reduce complications [ 20 , 21 ].…”

Evaluation of choroidal thickness, macular thickness, and aqueous flare after cataract surgery in patients with and without diabetes: a prospective randomized study

“…Most groups reported reduced CT in patients with diabetic retinopathy [26][27][28][29], and several groups reported that the choroid was thinner in eyes with diabetic macular edema (DME) [30][31][32]. Although some groups have reported CT after cataract surgery in patients with diabetes [33][34][35], the results have been inconsistent.…”

Evaluation of Choroid Thickness Changes After Uneventful Phacoemulsification Surgery Using Spectral Domain Optical Coherence Tomography at a Tertiary Care Eye Hospital

“…These inflammatory mediators pass from anterior chamber, vitreous to retina and choroid leading to impairment of inner and outer blood retinal barrier causing an inflammatory cascade. 18,19 Another mechanism suggested for post-surgical inflammation is increased gene expression that simultaneously induces inflammatory response in all ocular layers. In a mouse model cataract surgery increased protein secretion in the retina and choroid due to expression of pro inflammatory gene related to chemokines such as CCL-2 and SDF-1, both of which can impair the blood-retinal barrier.…”