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Incidence of cystoid macular oedema in diabetic patients after phacoemulsification and free radical link to its pathogenesis
  1. Anupam Samanta1,2,
  2. Premranjan Kumar2,
  3. Sanghamitra Machhua2,
  4. G Nageswar Rao1,
  5. Arttatrana Pal2
  1. 1Department of Ophthalmology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India
  2. 2School of Biotechnology, KIIT University, Bhubaneswar, India
  1. Correspondence to Dr Arttatrana Pal, Molecular biology Lab, School of Biotechnology, KIIT University, Bhubaneswar 751024, India; arttatrana{at}yahoo.com

Abstract

Purpose Postoperative onset of cystoid macular oedema (CME) in diabetic patients after cataract surgery is a frequent problem in working-age adults worldwide. Here, we investigate the postoperative development of CME in diabetic patients after undergoing phacoemulsification with other ailing factors associated with CME.

Methods This prospective study included 65 Type 2 diabetic patients with no diabetic retinopathy (DR), mild to moderate DR, moderate to severe DR and proliferative DR who underwent phacoemulsification surgery. Indirect ophthalmoscopy, fluorescein angiograms and optical coherence tomography were taken for a period of 8 weeks postoperatively to determine visual outcome and development of CME. Serum samples were collected for the measurement of antioxidants and reactive oxygen species (ROS) levels.

Results Our data showed that CME occurred postoperatively in 47% without pre-existing DR and 55% of eyes with pre-existing DR (p<005). Positive association was noticed between morbid conditions, like hypertension (p<0.01) and diabetic nephropathy (p<0.05), and postoperative incidence of CME. The activity of antioxidant enzymes in patients with DR was found to be lower as compared with diabetic (D) patients, but catalase activity was recorded the maximum in these patients. The ROS activity was recorded highest in the serum samples of DR becoming CME positive.

Conclusions The present results suggest that after phacoemulsification, the chance of development of CME in DR is more as compared to D. Moreover, the development of CME is significantly associated with decrease in antioxidant levels, increased ROS activities, hypertension, diabetic nephropathy, and hyperlipidaemia.

  • Biochemistry
  • Pathology
  • Public health
  • Treatment Surgery
  • Visual perception

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