Authors :
Dr. Nitisha Bhimavarapu; Dr. M. Parni Kumar
Volume/Issue :
Volume 9 - 2024, Issue 2 - February
Google Scholar :
http://tinyurl.com/524xceyt
Scribd :
http://tinyurl.com/me3acr3n
DOI :
https://doi.org/10.5281/zenodo.10696581
Abstract :
Purpose
Evaluate alterations in thickness of macula after
uncomplicated cataract surgery, to clarify the optical
tomographic characteristics of thickness of macula after
uncomplicated cataract surgery, and also compare the
changes in thickness of macula after uncomplicated
phacoemulsification and manual small incision cataract
surgery.
Patients and Methodology
The study included a cohort of fifty patients,
consisting of 28 males and 22 females. The age range of
the participants was between 35 and 78 years, with a
mean age of 58.6 years. Out of the total, 25 individuals
(50%) underwent small incision cataract surgery (SICS)
in one eye with "in the bag" method of intraocular lens
(IOL) made up of polymethylmethacrylate implantation,
while the other 25 participants (50%) underwent
phacoemulsification in one eye with "in the bag" method
of foldable IOL made up of acrylic.
The exclusion criteria included cataracts that were
too mature for pre-surgical OCT, pathology involving
the retina, traumatic or complex cataracts, and
complications during surgery. The measurement of best
corrected visual acuity was conducted, and optical
coherence tomography (OCT) was performed before and
after the surgery to assess macular thickness. The
patients were reviewed at one week, two week, and four
weeks post-surgery, as well as three months post-
surgery.
Outcome
Among the 50 participants who had undergone
cataract surgery, subclinical macular edema was
observed at the first week, second week , and fourth
week evaluations. The highest level of subclinical
macular edema was observed during the first week
evaluation. However, during the third month evaluation,
the macular edema had diminished. Statistically
significant differences (P<0.01) were observed between
the mean thickness of macula values before and after
surgery at the 1st, 2nd, and 4th week post-operation.
Within the SICS group Statistically significant
differences (P<0.01) were observed between the mean
macular thickness values before and after surgery in the
first, second, and fourth weeks. Within the Phaco group
Statistically significant differences (P<0.05) were
observed between the mean values of macular thickness
before surgery and during the first week after surgery,
before surgery and during the second week after
surgery, and during the first week after surgery and the
fourth week after surgery. A notable subclinical
alteration occurred in the thickness of the macula,
without any impact on visual acuity. None of the
participants in the current research exhibited cystoid
macular edema. Upon comparing both groups, it was
observed that the SICS group exhibited a prolonged
subclinical macular edema until the fourth week review.
Conversely, in patients who underwent
phacoemulsification, an increase in retinal thickness was
observed until the second week review. However, there
were no statistically significant differences in the average
macular thickness values between the two groups before
surgery (t (d.f.=46) = 0.98; P>0.05), at review of 1 week (t
(d.f.=46) = 1.08; P>0.05),review at 2 weeks (t (d.f.=46) =
0.74; P>0.05), review at 4 weeks (t (d.f.=46) = 0.64;
P>0.05), and review at 3 months (t (d.f.=46) = 0.23;
P>0.05) after surgery.
Conclusion
Subclinical macular edema develops following
uncomplicated cataract surgery, reaching its highest
point one week after the procedure and persisting for a
maximum of four weeks. The optical coherence
tomography (OCT) scan revealed the presence of
macular edema, which did not cause any changes to the
macular structure . The period of subclinical macular
edema is extended in eyes that undergo manual small
incision cataract surgery (SICS) compared to those that
undergo phacoemulsification. This edema does not have
any impact on visual acuity.
Keywords :
Manual Small Incision Cataract Surgery(SICS) , Phaco Emulsification , Optical Coherence Tomography(OCT), Polymethyl Methacrylate(PMMA) , Intraocular Lenses (Iols).
Purpose
Evaluate alterations in thickness of macula after
uncomplicated cataract surgery, to clarify the optical
tomographic characteristics of thickness of macula after
uncomplicated cataract surgery, and also compare the
changes in thickness of macula after uncomplicated
phacoemulsification and manual small incision cataract
surgery.
Patients and Methodology
The study included a cohort of fifty patients,
consisting of 28 males and 22 females. The age range of
the participants was between 35 and 78 years, with a
mean age of 58.6 years. Out of the total, 25 individuals
(50%) underwent small incision cataract surgery (SICS)
in one eye with "in the bag" method of intraocular lens
(IOL) made up of polymethylmethacrylate implantation,
while the other 25 participants (50%) underwent
phacoemulsification in one eye with "in the bag" method
of foldable IOL made up of acrylic.
The exclusion criteria included cataracts that were
too mature for pre-surgical OCT, pathology involving
the retina, traumatic or complex cataracts, and
complications during surgery. The measurement of best
corrected visual acuity was conducted, and optical
coherence tomography (OCT) was performed before and
after the surgery to assess macular thickness. The
patients were reviewed at one week, two week, and four
weeks post-surgery, as well as three months post-
surgery.
Outcome
Among the 50 participants who had undergone
cataract surgery, subclinical macular edema was
observed at the first week, second week , and fourth
week evaluations. The highest level of subclinical
macular edema was observed during the first week
evaluation. However, during the third month evaluation,
the macular edema had diminished. Statistically
significant differences (P<0.01) were observed between
the mean thickness of macula values before and after
surgery at the 1st, 2nd, and 4th week post-operation.
Within the SICS group Statistically significant
differences (P<0.01) were observed between the mean
macular thickness values before and after surgery in the
first, second, and fourth weeks. Within the Phaco group
Statistically significant differences (P<0.05) were
observed between the mean values of macular thickness
before surgery and during the first week after surgery,
before surgery and during the second week after
surgery, and during the first week after surgery and the
fourth week after surgery. A notable subclinical
alteration occurred in the thickness of the macula,
without any impact on visual acuity. None of the
participants in the current research exhibited cystoid
macular edema. Upon comparing both groups, it was
observed that the SICS group exhibited a prolonged
subclinical macular edema until the fourth week review.
Conversely, in patients who underwent
phacoemulsification, an increase in retinal thickness was
observed until the second week review. However, there
were no statistically significant differences in the average
macular thickness values between the two groups before
surgery (t (d.f.=46) = 0.98; P>0.05), at review of 1 week (t
(d.f.=46) = 1.08; P>0.05),review at 2 weeks (t (d.f.=46) =
0.74; P>0.05), review at 4 weeks (t (d.f.=46) = 0.64;
P>0.05), and review at 3 months (t (d.f.=46) = 0.23;
P>0.05) after surgery.
Conclusion
Subclinical macular edema develops following
uncomplicated cataract surgery, reaching its highest
point one week after the procedure and persisting for a
maximum of four weeks. The optical coherence
tomography (OCT) scan revealed the presence of
macular edema, which did not cause any changes to the
macular structure . The period of subclinical macular
edema is extended in eyes that undergo manual small
incision cataract surgery (SICS) compared to those that
undergo phacoemulsification. This edema does not have
any impact on visual acuity.
Keywords :
Manual Small Incision Cataract Surgery(SICS) , Phaco Emulsification , Optical Coherence Tomography(OCT), Polymethyl Methacrylate(PMMA) , Intraocular Lenses (Iols).
