Abstract
Background. One of the complications of diabetes mellitus is diabetic cataract, which may occur in combination with age-related cataract. Phacoemulsification of cataract with intraocular lens implantation is the gold standard for cataract treatment. However, in people with diabetes mellitus, the results of surgery may be accompanied by complications, including retinal changes, especially in the macular region. These include diabetic macular edema, pseudophakic macular edema, or a combination of both.
Aim. To study the characteristics of macular edema after cataract phacoemulsification in diabetic retinopathy and type 2 diabetes mellitus.
Materials and methods. The study included 178 patients (222 eyes) aged 45 to 76 years with type 2 diabetes mellitus and mild to moderate nonproliferative diabetic retinopathy. All patients underwent phacoemulsification of cataracts with intraocular lens implantation. After surgical treatment, all patients were examined for the development of diabetic macular edema, pseudophakic macular edema, or a combination of both, based on ophthalmoscopy and optical coherence tomography data during the nearest follow-up period of 3 months. Results. In the early postoperative period, a significant increase in area thickness was noted already on the first day (+1.56%; p = 0.032), with further progression to day 10 (+7.36%), 1 month (+8.57%), and 3 months (+10.17%) (p < 0.001). The CMT index increased statistically significantly starting from day 10 (+4.29%; p < 0.001) and remained elevated after 1 month (+5.58%) and 3 months (+7.73%) (p < 0.001), while on the 1st day the changes were insignificant (p = 0.41). Macular volume (MV) did not change significantly in the early stages (p > 0.05), but after 1 month, a significant increase was noted (+1.45%; p = 0.021) with a further increase after 3 months (+3.28%; p < 0.001). For TVR, no significant changes were observed until the 10th day (p > 0.05), while after 1 month (+2.12%) and 3 months (+3.46%) the indicator increased significantly (p < 0.001). On the first day, ophthalmoscopy of the fundus and OCT data did not reveal any edema in the macular region. On the 10th day, ophthalmoscopy and optical coherence tomography revealed diabetic macular edema and pseudophakic macular edema in 5.55% and 2.77% of cases, respectively. On day 1, diabetic macular edema and pseudophakic macular edema were diagnosed in 12.14% and 3.2% of cases, respectively. On day 3, diabetic macular edema, pseudophakic macular edema, and their combination were observed in 11.68%, 7.94%, and 4.2% of cases, respectively.
Conclusion. It has been established that pseudophakic macular edema or a combination of diabetic macular edema and pseudophakic macular edema is uncommon, but a typical complication of modern surgical treatment of cataracts in patients with type 2 diabetes mellitus and mild to moderate nonproliferative diabetic retinopathy