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Effect of cataract surgery on postoperative macular edema in patients with diabetic macular edema

Year 2016, , 29 - 33, 29.10.2016
https://doi.org/10.18663/tjcl.99701

Abstract

Aim: The aim of this study is to investigate the changes and effect of hemoglobin A1c in patients with diabetic macular edema following cataract surgery.

 Material and Methods: This retrospective clinical study included 30 eyes of 30 patients with diabetic macular edema who underwent phacoemulsification cataract surgery. Ophthalmological examination and optical coherence tomography evaluation of macula were performed at firstweek and first and third months.

 Results: Compared to baseline, best corrected visual acuity improved significantly at first and third month’s visits (P ˂ 0.05). In terms of foveal thickness, it was increased significantly at first and third months (P ˂ 0.05) and decreased by the end of first month. There was a positive correlation between hemoglobin A1c levels and foveal thickness (P = 0.030, r =0.38).

 Conclusion: Patients with diabetic macular edema and cataract seem to benefit from phacoemulsification surgery. They should be followed for postoperative macular edema with optical coherence tomography, particularly during the first six month.

 Key words: Diabetic macula edema, phacoemulsification, optical coherence tomography

 

References

  • Nelson ML, Martidis A. Managing cystoid macular edema after cataract surgery. Curr Opin Ophthalmol 2003; 14: 39-43.
  • Ray S, D’Amico DJ. Pseudophakic cystoid macular edema. Semin Ophthalmol 2002; 17: 167-80.
  • Cunliffe IA, Flanagan DW, George NDL, et al. Extracapsular cataract surgery with lens implantation in diabetics with and without proliferative retinopathy. Br J Ophthalmol 1991; 75: 9-12.
  • Schatz H, Atienza D, McDonald R, et al. Severe diabetic retinopathy after cataract surgery. Am J Ophthalmol 1994; 117: 314-21.
  • Aiello LP, Avery RI, Arrigg PG, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 1994; 331: 1480-7.
  • Canton A, Burgos R, Hernandez C, et al. Hepatocyte growth factor in vitreous and serum from patients with proliferative diabetic retinopathy. Br J Ophthalmol 2000; 84: 732-5.
  • Menchini N, Bandello F, Brancato R, et al. Cystoid macular edema after extracapsular cataract and intraocular lens implantation in diabetic patients without retinopathy. Br J Ophthalmol 1993; 77: 208-11.
  • Patel JI, Hykin PG, Cree IA. Diabetic cataract removal: postoperative progression of maculopathy-growth factor and clinical analysis. Br J Ophthalmol 2006; 90: 697-701.
  • Hee MR, Puliafito CA, Wong C, et al. Quantitative assessment of macular edema with optical coherence tomography. Arch Ophthalmol 1995; 113: 1019-29.
  • Goebel W, Kretzchmar-Gross T. Retinal thickness in diabetic retinopathy: a study using optical coherence tomography (OCT). Retina 2002; 22: 759-67.
  • Browning DJ, McOwen MD, Bowen RM Jr, O'Marah TL. Comparison of the clinical diagnosis of diabetic macular edema with diagnosis by optical coherence tomography. Ophthalmology 2004; 111: 712-5.
  • Meyer CH. Current treatment approaches in diabetic macular edema. Ophthalmologica 2007; 221: 118-31.
  • Gass JD, Norton EW. Cystoid macular edema and papilledema following cataract extraction. A fluorescein fundoscopic and angiographic study. Arch Ophthalmol 1966; 76: 646-61.
  • Benson WE. Cataract surgery and diabetic retinopathy. Curr Opin Ophthalmol 1992; 3: 396-400.
  • Dowler JG, Sehmi KS, Hykin PG, Hamilton AM. The natural history of macular edema after cataract surgery in diabetes. Ophthalmology 1999; 106: 663-8.
  • 16.Kwon SI, Hwang DJ, Seo YJ, Park IW. Evaluation of Changes of Macular Thickness in Diabetic Retinopathy after Cataract Surgery. Korean J Ophthalmol 2011; 25: 238-42.
  • Funatsu H, Yamashita H, Noma H, et al. Prediction of macular edema exacerbation after phacoemulsification in patients with nonproliferative diabetic retinopathy. J Cataract Refract Surg 2002; 28: 1355-63.
  • Krepler K, Biowski R, Schrey S, et al. Cataract surgery in patients with diabetic retinopathy: visual outcome, progression of diabetic retinopathy, and incidence of diabetic macular oedema. Graefes Arch Clin Exp Ophthalmol 2002; 240: 735-8.
  • Patel JI, Hykin PG, Cree IA. Diabetic cataract removal: postoperative progression of maculopathy—growth factor and clinical analysis. Br J Ophthalmol 2006; 90: 697-701.
  • Squirrell D, Bhola R, Bush J, et al. A prospective, case controlled study of the natural history of diabetic retinopathy and maculopathy after uncomplicated phacoemulsification cataract surgery in patients with type 2 diabetes. Br J Ophthalmol 2002; 86: 565-71.
  • Romero-Aroca P, Fernandez-Ballart J, Almena-Garcia M, et al. Nonproliferative diabetic retinopathy and macular edema progression after phacoemulsification: prospective study. J Cataract Refract Surg 2006; 32: 1438-44.
  • Hong T, Mitchell P, de Loryn T, et al. Development and progression of diabetic retinopathy 12 months after phacoemulsification cataract surgery. Ophthalmology 2009; 116: 1510-4.

Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi

Year 2016, , 29 - 33, 29.10.2016
https://doi.org/10.18663/tjcl.99701

Abstract

Amaç: Diyabetik makula ödemi olan hastalarda katarakt cerrahisi sonrası makula ödemindeki değişikliklerin ve hemoglobin A1C  (HbA1C) ile ilişkisinin incelenmesi.

Gereç ve Yöntemler: Bu retrospektif klinik çalışma diyabetik makula ödemi olan ve komplikasyonsuz fakoemülsifikasyon ameliyatı uygulanan 30 hastanın 30 gözünü kapsamaktadır. Olgulara operasyon öncesi ve sonrası 1. hafta 1. ay ve 3. aylarda oftalmolojik muayene yapıldı ve optik koherens tomografi (OKT) yardımıyla santral foveal kalınlık ölçümü yapıldı.

Bulgular: Başlangıç değerlerine göre en iyi düzeltilmiş görme keskinliği bakımından 1. ve 3. ay değerleri artma gösterdi ve bu farklılık istatistiksel olarak anlamlıydı (P ˂ 0.05). Foveal kalınlık bakımından da 1. ay ve 3. ay değerleri başlangıca göre istatistiksel olarak anlamlı derecede yüksek bulundu. Ancak 1 aydan sonra artma eğilimi azaldı. HbA1C ile ilk ay foveal kalınlık arasında anlamlı pozitif bir korelasyon bulundu. (P =  0.030,  r = 0 .38)

Sonuçlar: Diyabetik makula ödemi ve kataraktı olan hastalar fakoemülsifikasyonla katarakt cerrahisinden fayda görmektedir. Katarakt cerrahisi sonrası makula ödemi açısından özellikle ilk 6 ay OKT ile düzenli takip yapılmalıdır.

Anahtar kelimeler: Diyabetik makula ödemi, fakoemülsifikasyon, optik koherens tomografi

 

References

  • Nelson ML, Martidis A. Managing cystoid macular edema after cataract surgery. Curr Opin Ophthalmol 2003; 14: 39-43.
  • Ray S, D’Amico DJ. Pseudophakic cystoid macular edema. Semin Ophthalmol 2002; 17: 167-80.
  • Cunliffe IA, Flanagan DW, George NDL, et al. Extracapsular cataract surgery with lens implantation in diabetics with and without proliferative retinopathy. Br J Ophthalmol 1991; 75: 9-12.
  • Schatz H, Atienza D, McDonald R, et al. Severe diabetic retinopathy after cataract surgery. Am J Ophthalmol 1994; 117: 314-21.
  • Aiello LP, Avery RI, Arrigg PG, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 1994; 331: 1480-7.
  • Canton A, Burgos R, Hernandez C, et al. Hepatocyte growth factor in vitreous and serum from patients with proliferative diabetic retinopathy. Br J Ophthalmol 2000; 84: 732-5.
  • Menchini N, Bandello F, Brancato R, et al. Cystoid macular edema after extracapsular cataract and intraocular lens implantation in diabetic patients without retinopathy. Br J Ophthalmol 1993; 77: 208-11.
  • Patel JI, Hykin PG, Cree IA. Diabetic cataract removal: postoperative progression of maculopathy-growth factor and clinical analysis. Br J Ophthalmol 2006; 90: 697-701.
  • Hee MR, Puliafito CA, Wong C, et al. Quantitative assessment of macular edema with optical coherence tomography. Arch Ophthalmol 1995; 113: 1019-29.
  • Goebel W, Kretzchmar-Gross T. Retinal thickness in diabetic retinopathy: a study using optical coherence tomography (OCT). Retina 2002; 22: 759-67.
  • Browning DJ, McOwen MD, Bowen RM Jr, O'Marah TL. Comparison of the clinical diagnosis of diabetic macular edema with diagnosis by optical coherence tomography. Ophthalmology 2004; 111: 712-5.
  • Meyer CH. Current treatment approaches in diabetic macular edema. Ophthalmologica 2007; 221: 118-31.
  • Gass JD, Norton EW. Cystoid macular edema and papilledema following cataract extraction. A fluorescein fundoscopic and angiographic study. Arch Ophthalmol 1966; 76: 646-61.
  • Benson WE. Cataract surgery and diabetic retinopathy. Curr Opin Ophthalmol 1992; 3: 396-400.
  • Dowler JG, Sehmi KS, Hykin PG, Hamilton AM. The natural history of macular edema after cataract surgery in diabetes. Ophthalmology 1999; 106: 663-8.
  • 16.Kwon SI, Hwang DJ, Seo YJ, Park IW. Evaluation of Changes of Macular Thickness in Diabetic Retinopathy after Cataract Surgery. Korean J Ophthalmol 2011; 25: 238-42.
  • Funatsu H, Yamashita H, Noma H, et al. Prediction of macular edema exacerbation after phacoemulsification in patients with nonproliferative diabetic retinopathy. J Cataract Refract Surg 2002; 28: 1355-63.
  • Krepler K, Biowski R, Schrey S, et al. Cataract surgery in patients with diabetic retinopathy: visual outcome, progression of diabetic retinopathy, and incidence of diabetic macular oedema. Graefes Arch Clin Exp Ophthalmol 2002; 240: 735-8.
  • Patel JI, Hykin PG, Cree IA. Diabetic cataract removal: postoperative progression of maculopathy—growth factor and clinical analysis. Br J Ophthalmol 2006; 90: 697-701.
  • Squirrell D, Bhola R, Bush J, et al. A prospective, case controlled study of the natural history of diabetic retinopathy and maculopathy after uncomplicated phacoemulsification cataract surgery in patients with type 2 diabetes. Br J Ophthalmol 2002; 86: 565-71.
  • Romero-Aroca P, Fernandez-Ballart J, Almena-Garcia M, et al. Nonproliferative diabetic retinopathy and macular edema progression after phacoemulsification: prospective study. J Cataract Refract Surg 2006; 32: 1438-44.
  • Hong T, Mitchell P, de Loryn T, et al. Development and progression of diabetic retinopathy 12 months after phacoemulsification cataract surgery. Ophthalmology 2009; 116: 1510-4.
There are 22 citations in total.

Details

Journal Section Orıgınal Artıcle
Authors

Erhan Yumuşak

Kemal Örnek

Publication Date October 29, 2016
Published in Issue Year 2016

Cite

APA Yumuşak, E., & Örnek, K. (2016). Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi. Turkish Journal of Clinics and Laboratory, 7(2), 29-33. https://doi.org/10.18663/tjcl.99701
AMA Yumuşak E, Örnek K. Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi. TJCL. June 2016;7(2):29-33. doi:10.18663/tjcl.99701
Chicago Yumuşak, Erhan, and Kemal Örnek. “Diabetik Makula ödemi Olan Hastalarda Katarakt Cerrahisinin Postoperatif Makula ödemine Etkisi”. Turkish Journal of Clinics and Laboratory 7, no. 2 (June 2016): 29-33. https://doi.org/10.18663/tjcl.99701.
EndNote Yumuşak E, Örnek K (June 1, 2016) Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi. Turkish Journal of Clinics and Laboratory 7 2 29–33.
IEEE E. Yumuşak and K. Örnek, “Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi”, TJCL, vol. 7, no. 2, pp. 29–33, 2016, doi: 10.18663/tjcl.99701.
ISNAD Yumuşak, Erhan - Örnek, Kemal. “Diabetik Makula ödemi Olan Hastalarda Katarakt Cerrahisinin Postoperatif Makula ödemine Etkisi”. Turkish Journal of Clinics and Laboratory 7/2 (June 2016), 29-33. https://doi.org/10.18663/tjcl.99701.
JAMA Yumuşak E, Örnek K. Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi. TJCL. 2016;7:29–33.
MLA Yumuşak, Erhan and Kemal Örnek. “Diabetik Makula ödemi Olan Hastalarda Katarakt Cerrahisinin Postoperatif Makula ödemine Etkisi”. Turkish Journal of Clinics and Laboratory, vol. 7, no. 2, 2016, pp. 29-33, doi:10.18663/tjcl.99701.
Vancouver Yumuşak E, Örnek K. Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi. TJCL. 2016;7(2):29-33.


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