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- DOI 10.18231/j.ijceo.v.11.i.3.7
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CrossMark
Changes in central macular thickness after uneventful phacoemulsification in diabetics and non-diabetics using normothermic and hypothermic balanced salt solution in a tertiary care hospital in Tamil Nadu
- Author Details:
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Vengateshwaran Rajendran
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Premnath Gnaneswaran *
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Shruthi Devi Suresh
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Shankar Chokkalingam
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Adnan Mohamed Matheen
Vengateshwaran Rajendran
Premnath Gnaneswaran *
Shruthi Devi Suresh
Shankar Chokkalingam
Adnan Mohamed Matheen
Background: Central macular thickness (CMT) may undergo significant changes after cataract surgery, particularly in diabetic individuals. The temperature of balanced salt solution (BSS) used during phacoemulsification may influence postoperative inflammatory response and macular changes.
Aim and Objective: To assess and compare the central macular thickness (CMT) in diabetic and non-diabetic patients undergoing phacoemulsification using normothermic and hypothermic BSS.
Materials and Methods: The study consisted of 140 participants divided equally into four groups of 35 each. Group 1 – NDMR: Nondiabetics who received room temperature BSS; Group 2 – NDMC: Nondiabetics who received cold BSS; Group 3 – DMR: Diabetics who received room temperature BSS; and Group 4 – DMC: Diabetics who received cold BSS. The cold BSS used was at a temperature of 4oC and room temperature BSS used was normothermic and was in the range between 34 – 36oC. CMT was measured pre and post-operatively using a spectral domain optical coherence tomography scan and compared.
Results: The CMT values were significantly different between the NDMR (non-diabetic patients receiving room temperature BSS) and NDMC (non-diabetic patients receiving cold [4oC] BSS) consistently at POD 7, 28 and 42, with CMT being higher in those who were given room temperature BSS.
Conclusion: The incidence of cystoid macular edema is less in non-diabetics than diabetics who were subjected to hypothermic BSS.
References
- Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, et al. The lens opacities classification system III. Arch Ophthalmol. 1993;111(6):831–6.
- Solomon R, Donnenfeld ED. Recent advances and future frontiers in treating age-related cataracts. JAMA. 2003;290(2):248–51.
- Chaurasia RK, Khasnavis A, Mittal J. Comparison of corneal endothelial changes following phacoemulsification in diabetic and non-diabetic patients. Indian J Ophthalmol. 2022;70(4):1208–13.
- Dasari N, Jiang A, Skochdopole A, Chung J, Reece EM, Vorstenbosch J, et al. Updates in diabetic wound healing, inflammation, and scarring. Semin Plast Surg. 2021;35(3):153–8.
- Burgess JL, Wyant WA, Abujamra BAA, Kirsner RS, Jozic I. Diabetic wound-healing science. Medicina (Kaunas). 2021;57(10):1072.
- Swoboda L, Held J. Impaired wound healing in diabetes. J Wound Care 2022;31(10):882–5.
- Grzybowski A, Kanclerz P, Huerva V, Ascaso FJ, Tuuminen R. Diabetes and phacoemulsification cataract surgery: difficulties, risks and potential complications. J Clin Med. 2019;8(5):716. Rajendran et al. / Indian Journal of Clinical and Experimental Ophthalmology 2025;11(3):406–411 411
- Agarwal R, Gupta PK, Gupta K. Macular edema after uncomplicated phacoemulsification in type 2 diabetics with NPDR. Int J Health Clin Res. 2020;3(5):142–7.
- Holló G, Aung T, Cantor LB, Aihara M. Cystoid macular edema related to cataract surgery and topical prostaglandin analogs: Mechanism, diagnosis, and management. Surv Ophthalmol. 2020;65(5):496–512.
- Gass JDM, Norton EWD. Cystoid macular edema and papilledema following cataract extraction: a fluorescein fundoscopic and angiographic study. Retina. 2003;23(6 Suppl):646–61.
- Yuksel E, Ozdemir B, Cubuk MO. Balanced salt solution-assisted intraocular lens implantation in phacoemulsification surgery: intraocular pressure and endothelial cell effects. Beyoglu Eye J. 2019;4(1):5–10.
- Trichonas G, Kaiser PK. Optical coherence tomography imaging of macular oedema. Br J Ophthalmol. 2014;98 Suppl 2:ii24–9.
- Gabai A, Zeppieri M, Finocchio L, Salati C. Innovative strategies for drug delivery to the ocular posterior segment. Pharmaceutics. 2023;15(7):1862.
- Ricciotti E, FitzGerald GA. Prostaglandins and inflammation. Arterioscler Thromb Vasc Biol. 2011;31(5):986–1000.
- Akkaya S. Changes in central macular thickness after uncomplicated phacoemulsification surgery in diabetic and non diabetic patients. Beyoglu Eye J. 2018;3(1):13–19.
- Meduri A, Bergandi L, Oliverio GW, Rechichi M, Acri G, Perroni P, et al. The cold eye irrigation BSS solution used during phacoemulsification reduces post-surgery patients discomfort preventing the inflammation. Eur J Ophthalmol. 2022;32:911–7.
- Miller KM, Oetting TA, Tweeten JP, Carter K, Lee BS, Lin S, et al. Cataract in the adult eye preferred practice pattern. Ophthalmology. 2022;129(1):P1–126.
- Meduri A, Oliverio GW, Bergandi L, De Salvo G, Frisina R, Mazzotta C, et al. Role of cold balanced salt solution (bss) in the prophylaxis of cystoid macular edema after cataract surgery: A prospective randomized study. Clin Ophthalmol. 2021;15:2519–26.
- Ikegami Y, Takahashi M, Amino K. Evaluation of choroidal thickness, macular thickness, and aqueous flare after cataract surgery in patients with and without diabetes: a prospective randomized study. BMC Ophthalmol 2020;20(1):102.
- Shafi M, Khan MA, Lodhi Y, Aftab A, Sarfraz MH. Central macular thickness after cataract surgery in non-diabetics and diabetics without retinopathy. Pak Armed Forces Med J. 2021;71(6):1993–
- Degenring RF, Vey S, Kamppeter B, Budde WM, Jonas JB, Sauder G. Effect of uncomplicated phacoemulsification on the central retina in diabetic and non-diabetic subjects. Graefes Arch Clin Exp Ophthalmol. 2007;245(1):18–23.
- Romero-Aroca P. Targeting the pathophysiology of diabetic macular edema. Diabetes Care. 2010;33(11):2484–5.
- Pradeepa R, Mohan V. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021;69(11):2932–8.
- Mohan V. Why are Indians more prone to diabetes? J Assoc Physicians India. 2004;52:468–74.
- Hayashi K, Nakao F, Hayashi F. Corneal endothelial cell loss after phacoemulsification using nuclear cracking procedures. J Cataract Refract Surg. 1994;20(1):44–7.