Bamahfouz Ashjan
Ophthalmology, Umm Al-Qura University, Mecca, SAU.
Cureus. 2021 Mar 12;13(3):e13856. doi: 10.7759/cureus.13856.
Purpose To estimate the incidence of central macular edema (CME) following cataract surgery and to correlate the central macular thickness (CMT) to the best-corrected visual acuity (BCVA). Methods This cohort study in 2018-2019 included cataract grades I and II. They were operated by phacoemulsification and intraocular lens implantation. CMT was measured using spectral-domain optical coherence tomogram (OCT) before and for three months at one-month intervals after surgery. The change in BCVA and CMT were correlated at three months after surgery. Incidence of CME (more than two SD of pre-surgery CMT) was calculated. Results The mean CMT for 138 eyes operated for cataracts measured before and at one, two, and three months after uneventful surgery was 213 ± 24.9, 222.7 ± 25.5, 217.8 ± 34.8, and 215 ± 28.3 µ, respectively. The median BCVA at three follow-ups was 0.2 (interquartile range [IQR] 0.1; 0.2), 0.1 (IQR 0.0; 0.1), and 0.0 (0.0; 0.03), respectively. The incidence of CME at one and three months was 18% and 4.3%, respectively. The CMT and VA (LogMAR) one month after cataract surgery were significantly correlated (r = 0.4, Pearson P < 0.001). The visual improvement between one and two months post-surgery was not significantly correlated with CMT decline (r = 0.06, Pearson P = 0.5). The BCVA at one, two, and three months was 0.0 LogMAR in 28 (20.3%), 52 (37.7%), and 104 (75.4%) eyes, respectively. Linear regression model, age and diabetes are the risk factors at one month. At two and three months, no significant risk factors were found. Conclusion CME post-cataract surgery seems to be transient. CMT changes correlate with best-corrected vision changes and seem to be affected by age and presence of diabetes in the 1st month after surgery.
评估白内障手术后中心性黄斑水肿（CME）的发生率，并将中心黄斑厚度（CMT）与最佳矫正视力（BCVA）进行关联分析。方法：这项队列研究纳入了2018 - 2019年的I级和II级白内障患者。所有患者均接受了超声乳化白内障吸除术及人工晶状体植入术。术前及术后1个月、2个月、3个月，每隔1个月使用光谱域光学相干断层扫描（OCT）测量CMT。术后3个月时，分析BCVA和CMT的变化相关性。计算CME的发生率（术后CMT超过术前标准差2倍以上）。结果：138例白内障手术患者术后恢复顺利，术前及术后1个月、2个月、3个月的平均CMT分别为213±24.9、222.7±25.5、217.8±34.8及215±28.3µm。三次随访时的BCVA中位数分别为0.2（四分位数间距[IQR]0.1；0.2）、0.1（IQR 0.0；0.1）及0.0（0.0；0.03）。术后1个月和3个月时CME的发生率分别为18%和4.3%。白内障手术后1个月时CMT与视力（LogMAR）显著相关（r = 0.4，Pearson检验P < 0.001）。术后1个月至2个月间视力改善与CMT下降无显著相关性（r = 0.06，Pearson检验P = 0.5）。术后1个月、2个月、3个月时，BCVA为0.0 LogMAR的眼数分别为28只（20.3%）、52只（37.7%）及104只（75.4%）。线性回归模型显示，年龄和糖尿病是术后1个月时的危险因素。术后2个月和3个月时，未发现显著危险因素。结论：白内障手术后的CME似乎是短暂的。CMT变化与最佳矫正视力变化相关，且在术后第1个月似乎受年龄和糖尿病的影响。
