Evaluation of Visual Acuity, Macular Status, and Subfoveal Choroidal Thickness Changes After Cataract Surgery in Eyes With Diabetic Retinopathy

Brito, Pedro Quelhas; Rosas, Vitor; Coentrão, Luís M.; Carneiro, Ângela; Rocha‐Sousa, Amândio; Brandão, Elisete; Falcão‐Reis, Fernando; Falcão, Manuel

doi:10.1097/iae.0000000000000298

Cited by 36 publications

(34 citation statements)

References 24 publications

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“…The main finding of our study was the lack of a significant difference in CT after cataract surgery in both groups and between diabetic eyes and non-diabetic eyes during the follow-up period. Our findings confirmed the correlation between CT and cataract surgery reported by Brito et al [34] and Falcão et al [23] In these studies, cataract surgery did not induce choroidal changes, and the CT was free of the inflammation of the anterior chamber and inner retina caused by BRB disturbance. The absence of change in CT might be due to the fact that the retinal capillaries have a BRB and are autoregulated, whereas the choroidal capillaries are not autoregulated and thus behave differently from the retinal vessels.…”

Section: Discussionsupporting

confidence: 92%

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

Ikegami¹,

Takahashi

Amino

2020

Preprint

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Background: In diabetic eyes, various choroidal abnormalities are noted in addition to changes in the retinal circulation, and the risk of increased aqueous flare and retinal thickening after cataract surgery is higher in diabetic eyes. Inflammation caused by surgery induces breakdown of the blood-retinal barrier and affects the retina, although the influence on the choroid is unknown. Several researchers have evaluated the choroidal thickness (CT) after cataract surgery in patients with diabetes; however, the results are inconsistent. The purpose of this study was to evaluate the influence of uneventful small-incision phacoemulsification cataract surgery on the subfoveal choroidal thickness (SCT), the central macular thickness (CMT), and aqueous flare in patients with diabetes.Methods: This study included 59 randomly selected eyes (33 eyes of patients with diabetes and 26 eyes of control patients without diabetes) undergoing small-incision cataract surgery. Among the diabetic eyes, 26 were without diabetic retinopathy, and the remaining eyes had non-proliferative diabetic retinopathy. Aqueous flare, CMT, and SCT measurements were performed before and at 1 week, 1 month, and 3 months after surgery. Results: The postoperative CMT continued to increase significantly until 3 months in both groups. Although the CMT was more in patients with diabetes than in patients without diabetes during the follow-up period, there was no significant difference between the two groups. The aqueous flare value increased until 3 months after surgery in both groups. Although the increase was significant at 3 months after surgery in patients with diabetes, the increase in controls was not significant. The aqueous flare values differed significantly between the two groups before and at 3 months after surgery. There was no significant within-group or between-group difference in pre- and postoperative SCT values. Conclusion: In diabetic eyes with early stage of retinopathy, even small-incision cataract surgery can induce increased aqueous flare and macular thickening until 3 months, although there is no significant change in the choroidal thickness. Further studies are essential to evaluate choroidal changes after the cataract surgery in diabetic eyes.

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Section: Discussionsupporting

confidence: 92%

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

Ikegami¹,

Takahashi

Amino

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Themain finding of our study was the lack of a significant difference in CT after cataract surgery in both groups and between diabetic eyes and non-diabetic eyes during the follow-up period. Our findings confirmed the correlation between CT and cataract surgery reported by Brito et al [34] and Falcão et al [23] In these studies, cataract surgery did not induce choroidal changes, and the CT was free of the inflammation of the anterior chamber and inner retina caused by BRB disturbance. The absence of change in CT might be due to the fact that the retinal capillaries have a BRB and are autoregulated, whereas the choroidal capillaries are not autoregulated and thus behave differently from the retinal vessels.…”

Section: Discussionsupporting

confidence: 92%

“…A possible reason for this result is that the eyes included in this study had no retinopathy or were in the early stage of retinopathy. In the early stage of diabetes, the diabetic angiopathic changes tend to be less severe in the choroidal capillaries and therefore cannot be detected by SD-OCT [34]. Lee et al suggested that the functional integrity of the choroid in diabetic retinopathy is preserved after initial damage because the choroid is relatively resistant to the effects of diabetic retinopathy owing to a surplus of choroidal vessels and sufficient blood flow [43].…”

Section: Discussionmentioning

confidence: 99%

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

Ikegami¹,

Takahashi

Amino

2019

Preprint

View full text Add to dashboard Cite

Background In diabetic eyes, various choroidal abnormalities are noted in addition to changes in the retinal circulation, and the risk of increased aqueous flare and retinal thickening after cataract surgery is higher in diabetic eyes. Inflammation caused by surgery induces breakdown of the blood-retinal barrier and affects the retina, although the influence on the choroid is unknown. Several researchers have evaluated the choroidal thickness (CT) after cataract surgery in patients with diabetes; however, the results are inconsistent. The purpose of this study was to evaluate the influence of uneventful small-incision phacoemulsification cataract surgery on the subfoveal choroidal thickness (SCT), the central macular thickness (CMT), and aqueous flare in patients with diabetes.Methods This study included 59 randomly selected eyes (33 eyes of patients with diabetes and 26 eyes of control patients without diabetes) undergoing small-incision cataract surgery. Among the diabetic eyes, 26 were without diabetic retinopathy, and the remaining eyes had non-proliferative diabetic retinopathy. Aqueous flare, CMT, and SCT measurements were performed before and at 1 week, 1 month, and 3 months after surgery.Results The postoperative CMT continued to increase significantly until 3 months in both groups. Although the CMT was more in patients with diabetes than in patients without diabetes during the follow-up period, there was no significant difference between the two groups. The aqueous flare value increased until 3 months after surgery in both groups. Although the increase was significant at 3 months after surgery in patients with diabetes, the increase in controls was not significant. The aqueous flare values differed significantly between the two groups before and at 3 months after surgery. There was no significant within-group or between-group difference in pre- and postoperative SCT values.Conclusion In diabetic eyes with early stage of retinopathy, even small-incision cataract surgery can induce increased aqueous flare and macular thickening until 3 months, although there is no significant change in the choroidal thickness. Further studies are essential to evaluate choroidal changes after the cataract surgery in diabetic eyes.

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“…Brito PN et al found 11% increase in CMT in 25.7% of patients with DR, not given intravitreal injection during cataract surgery 3. Chen XY et al in their study on 92 eyes found that patients already suffering from DR have more chances of development of ME after cataract surgery 12.…”

Section: Discussionmentioning

confidence: 97%

“…ME after cataract surgery further jeopardizes vision, already worsened by Non-Proliferative Diabetic Retinopathy (NPDR). One study found an increase in CMT of at least 11% in 25.7% of the eyes with NPDR 3. ME is mainly caused by the accumulation of extracellular fluid within the retina due to leakage from dilated capillaries.…”

Section: Introductionmentioning

confidence: 99%

Effect of topical nepafenac in prevention of macular edema after cataract surgery in patients with nonproliferative diabetic retinopathy

Sarfraz¹,

Haq²,

Mehboob³

2017

Pak J Med Sci

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Objective:To determine the efficacy of topical Nepafenac (0.1%), administered post-operatively in prevention of Macular Edema (ME), after cataract surgery in patients with Non-Proliferative Diabetic Retinopathy (NPDR).Methods:This randomized control trial was conducted at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from Sep 2015 to Sep 2016. Sixty eyes of 60 patients with NPDR underwent phacoemulsification with intraocular lens implantation. Group 1 received 0.1% Nepafenac, 8-hourly, in operated eye after cataract surgery for three months, along with routine post-operative medications. Group-2 received only routine post-operative medications. ME was defined as increase in Central Macular Thickness (CMT) of >10% from pre-operative baseline, measured using spectral domain optical coherence tomography.Results:Mean age of study population was 60.97±4.91 years. Out of 60 patients, 34 (56.7%) were males and 24 (43.3%) were females. Mean pre-operative CMT, 3 months post-operative CMT, mean change in CMT and mean frequency change in CMT of Group-1 was 226.5±10.86µm, 228.83±14.56 µm, 2.33±10.45 µm and 1.05% respectively. Mean pre-operative CMT, three months post-operative CMT, mean change in CMT and mean frequency change in CMT in Group-2 was 223.93±11.69µm, 236.17±16.16 µm, 12.23±12.40µm and 5.51% respectively. ME was observed in one patient (3.3%) in Group-1, and seven patients (23.3%) in Group 2. The difference of mean change in CMT and frequency change in CMT between groups was statistically significant (p<0.05).Conclusion:0.1% topical Nepafenac is effective in prevention of macular edema after cataract surgery in patients with non-proliferative diabetic retinopathy (NPDR).

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Evaluation of Visual Acuity, Macular Status, and Subfoveal Choroidal Thickness Changes After Cataract Surgery in Eyes With Diabetic Retinopathy

Cited by 36 publications

References 24 publications

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

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

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

Effect of topical nepafenac in prevention of macular edema after cataract surgery in patients with nonproliferative diabetic retinopathy

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