Comparison of phacoemulsification parameters effect on macular thickness changes after uneventful phacoemulsification in diabetic and non-diabetic patients

Abstract

AIM: To evaluate the effect of phacoemulsification(phaco)parameters in micropulse phaco-tecnology with chamber stabilization environment(CASE)and increased control and efficiency(ICE)mode on central foveal thickness(CFT)changes after uneventful cataract surgery in normal and diabetic patients without retinopathy.METHODS: In this prospective study a total of 120 patients consist of 60 patients with type 2 diabetes mellitus as a diabetic group(DG)without retinopathy and 60 normal subjects as a control group(CG)who underwent uneventful phaco were evaluated. Intraoperative phacoemulsification parameters including phaco time(PT), and effective phaco time(EPT)were recorded. The CFT measurements were performed preoperatively, at 1 and 3mo postoperatively. The CFT differences were calculated in each exam.RESULTS:The mean PT in DG was 1.40±0.43min and it was 1.44±0.32min in CG, the difference was not significant(P=0.85). The mean EPT was 20.12±8.82s and 19.24±9.02s in DG and CG respectively which was statistically insignificant(P=0.964). The mean preoperative CFT was 218.4±12.0 μm in DG and 222.1±16.6 μm in CG which was not statistically different(P=0.168). The mean increment of CFT in DG was 30.3±37.2 μm at 1mo postoperatively, while it was 13.1±12.5 μm in CG. Even the CFT increments were significant in both groups at 1mo postoperatively, it was statistically higher in DG than that of CG(P=0.001). The average CFT increment at 3mo postoperatively comparing to preoperative level was 12.5±12.4 μm and 4.6±9.7 μm in DG and CG respectively. The increment of CFT was significantly higher in DG than that of CG(P=0.00). But the comparison of the mean CFTs changes from postoperative 1mo and 3mo in both DG and CG, significant decrements were observed in each group(P=0.00 and P=0.03 respectively).CONCLUSION: The significant increment of CFT following uneventful phaco. With the similar phaco parameters were observed in both normal and diabetic subjects. The CFT changes were higher in DG than that of CG but fortunately these were mostly subclinical and optic coherence tomography(OCT)based changes and regressed or disappeared after 3mo postoperatively therefore not require immediate treatment in both group.

Keywords

• phacoemulsification
• diabetic macular edema
• phacoemulsification time
• effective phacoemulsification time