Study of Central Macular Thickness before and after Cataract Surgery

Abstract

Background

The common forms of cataract surgery are phacoemulsification and manual small Incision surgery (MSICS). Increase in central macular thickness (CMT) has been reported to develop even after uncomplicated cataract surgery with best corrected visual acuity (BCVA) 20/20. Monitoring CMT may help us to detect it early and start the early treatment so that the patient can have the best vision after cataract surgery.

Methodology: This prospective observational study was carried out at a tertiary hospital in Puducherry after getting approval from the institutional research and ethics committee. All patients undergoing standard phacoemulsification and MSICS were enrolled in the study after taking written and informed consent, following strict inclusion and exclusion criteria. Preoperative CMT measurement was performed using spectral domain - Optical coherence tomography (SD-OCT). Postoperatively CMT was measured at 1 week, 3rd week, and 6th week of follow-up.

Results: Eighty-seven participants underwent phacoemulsification and 63 underwent MSICS. The majority of the participants were in the 51-60 years age group. The mean preoperative CMT was 217.3 ± 19.1 µm in the phacoemulsification group which reached 236.1 ± 16.3 µm in 6th week. The change in CMT in the phacoemulsification group was statistically significant p<0.05. In the MSICS group the mean CMT increased from 224.7 ± 21.8 µm pre-operatively to 254.6 ± 21.4 by the 6th week which was statistically significant.

Conclusions: Uncomplicated cataract surgery can result in a significant increase in CMT post-operatively. MSICS causes a slightly higher increase in CMT compared to phacoemulsification.