Evaluation of central corneal thickness as measured by pentacam and retinal and choroidal thickness as measured by optical coherence tomography before and after uneventful cataract phacoemulsification in normal and diabetic patients without retinopathy

Abstract

Introduction Cataract phacoemulsification surgery is the commonest ophthalmological surgical procedure performed worldwide. In spite of the relative short duration, small incision, and relative low power used during the procedure, it causes an inflammatory reaction, compression, and hypoxia to the tissues. Every step of this maneuver can cause direct effects on tissue and ocular pressure fluctuation, which may lead to disruption of the corneal endothelium, blood–aqueous barrier, and blood–retinal barrier, leading to postoperative corneal edema, increased macular, and choroidal thickness. Purpose The purpose of this study was to evaluate central foveal thickness (CFT) changes and subfoveal choroidal thickness (SFCT) changes using spectral domain optical coherence tomography and central corneal thickness (CCT) changes using Pentacam, before and after cataract surgery, and to compare the results between two groups, that is, normal and diabetic patients without retinopathy. Patients and methods A prospective study was conducted, in which 40 eyes of 40 patients, 20 nondiabetic and 20 diabetic without retinopathy, who underwent cataract phacoemulsification were examined preoperatively, 1 week postoperatively, and 1 month postoperatively. The study was done in Kobri El-Kobba Military Hospital during the period from May to November 2017. Results Preoperative CCT was significantly higher in diabetic group than the nondiabetic group. There was also a significant increase in CCT 1 week postoperatively in both group, reaching its peak, and then gradual decrease to near preoperative values 1 month postoperatively. There was no significant difference in preoperative and postoperative CFT values between the two groups. CFT continued to increase till 1 month postoperatively reaching values significantly higher than preoperative values at 1 week and 1 month postoperatively. The preoperative SFCT was significantly higher in diabetic group than the nondiabetic group with no significant differences in the postoperative values between the two groups; it also continued to increase till 1 month postoperatively, reaching values significantly higher than preoperative values at 1 week and 1 month postoperatively. Conclusion Cataract phacoemulsification leads to temporary increase in CCT and long-term increases in CFT and SFCT in both diabetic and nondiabetic patients. Diabetic patients have higher central corneal thickness and higher SFCT than nondiabetics.

Keywords

• cataract
• central corneal thickness
• central foveal thickness
• phacoemulsification
• subfoveal choroidal thickness