Posters

Risk factors of CME in diabetic patients undergoing cataract surgery

Poster Details

First Author: P. Ylinen FINLAND

Co Author(s):    I. Laine   J. Lindholm   H. Hippala   R. Tuuminen           

Abstract Details

Purpose:

To specify the risk factors for postoperative cystoid macular edema (CME) following cataract surgery in diabetic patients.

Setting:

Prospective single-center study. One-hundred two eyes of type I and II diabetic patients undergoing routine cataract surgery.

Methods:

Spectral Domain (SD)-OCT-imaging was conducted preoperatively at the day 0 and at one-month post-operative visit. Clinical characteristics (ocular posterior segment status, duration and type of diabetes, glycemic control, topical and systemic medication) and surgical parameters (e.g. phaco energy, operation time, use of pupil extension device) were recorded. Main outcome measure: Change in mean central retinal thickness (CRT) and incidence of CME at one-month.

Results:

Preoperatively CRT was 288+-55.6mcm and at one-month 300+-64.0mcm (mean+-SD). Clinically relevant CME was observed in 6 patients. CRT increase was greater in type I compared to type II diabetic patients (p=0.014), and in those having diabetic maculopathy (p=0.001), proliferative form of diabetic retinopathy (p<0.001), and in type II diabetic patients with insulin dependence (p=0.047), when compared to those without. Furthermore, serum glycosylated hemoglobin (HbA1c) concentration reflecting poor glycemic control correlated with CRT increase (r=0.523, p<0.001). Diabetic patients with dry age-related macular degeneration (AMD) had smaller increase in CRT at one-month than those without dry AMD (p<0.001).

Conclusions:

Despite improved systemic and ocular management of disease, diabetes yet remains a risk factor for the development of CME after cataract surgery. Clinical characteristics such as poor glycemic control, insulin dependence and diabetic retinal manifestations predispose to risk of postoperative CME. This study outlines the importance to identify, effectively treat and in select cases follow those diabetic patients at great risk for post-operative CME.

Financial Disclosure:

NONE