First Author: P.Bulir CZECH REPUBLIC
Co Author(s):
Purpose:
The aim of this study was OCT mesarument of macular thickness before and one week after cataract surgery with only topical anesthesia (GROUP1) compare to eyes with topical plus intracameral anesthesia of lidocain 1% preservative free (GROUP2).
Setting:
: Department, Hospital Liberec, Czech republic
Methods:
Intracameral application of preservative free lidocain 1% is used as an addition to topical anesthesia. Based on study on rats lidocain can have toxic impact on ganglion cells. It has been proved that phacoemulisification has impact on macular thickness measured by OCT. The aim of this study was to measure macular thickness before and after uncomplicated cataract surgery and compare change of thickness by perifoveolar and parafoveolar part of retina by GROUP1 and GROUP2. In prospective study 20eyes in each group were analyzed. Patients with macular disease, glaucoma and other conditions having impact on RNFL thickness were excluded from this study. Mean of age by GROUP1 was 72,9(+/- 5,7) years 7 of them females, 3males. Mean of age by GROUP2 71,5(+/- 5,8) years, 5 of them females, 5males. Parafoveolar (3mm) and perifoveolar (5mm) thickness in 4 sectors was measured by OCT-Optovue one hour before surgery and one week after surgery. 20 eyes underwent cataract procedure only with topical anesthesia and 20 eyes underwent procedure under topical and intracameral instillation of preservative free lidocain 1%. Surgeries were performed by the same surgeon, clear cornea incision 2.65mm, implantation of hydrophobic acrylic IOL was performed. Students t-test was used for statistically analysis.
Results:
There was significant increase of macular thickness by GROUP1 and GROUP 2 one week after surgery. Mean thickness of GROUP1 preoperatively was 293µm (SD:18.6, n=160) postoperatively 303 µm (SD:18.6, n=160) Difference of means is statistically significant (p<0.001), Mean thickness by GROUP2 preoperatively was 293 µm (SD:19.8, n=160) postoperatively 306 µm (SD:19.1, n=160) Difference of means is statistically significant (p<0.001) Means of change of macular thickness by GROUP A was 10.3 µm (SD:7.96, n=160) by GROUP B was 12.7 µm (SD:9.1, n=160) Difference of means was statistically significant (p=0.015).
Conclusions:
Although difference of means comparing GROUP1 and GROUP2 is statistically significant this difference comparing to normative database of macular thickness doesnt exceed the range to be clinically significant. The increase in macular thickness was sub-clinical and did not affect final visual outcome in any patient. Further studies should examine whether there is any correlation between this difference of macular thickness and difference in function. Studies should examine not just the anatomical changes but also the functional changes like BCVA, contrast sensitivity, microperimetry etc. Further studies should examine thickness of retina also 1month, 3month after surgery.
Financial Disclosure:
None
