Assessment for Macular Thickness after Uncomplicated Phacoemulsification Using Optical Coherence Tomography

• Published in: Korean journal of ophthalmology Vol. 36; no. 4; pp. 296 - 305
• Main Authors: Kim, Byung-Jin, Ahn, Ye Jin, Oh, Hye-Young, Choi, Soon Il, Yoo, Young-Sik, Whang, Woong-Joo, Byun, Yong-Soo, Lee, Mee-Yon, Joo, Choun-Ki
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Ophthalmological Society 01-08-2022
• Subjects: Original; epinephrine; macular edema; optical coherence tomography; cataract surgery; central macular thickness
• ISSN: 1011-8942; 2092-9382
• DOI: 10.3341/kjo.2021.0171

Macular edema including cystoid macular edema is one of the main causes of unfavorable visual outcomes after cataract surgery. The macular thickness and the occurrence of macular edema after uncomplicated cataract surgery was evaluated using optical coherence tomography (OCT) in this study.
Macular map images were taken by OCT before surgery and at 1 week, 1 month, and 2 months post-surgery. The subjects were classified into two groups (group 1: no macular edema group; group 2: macular edema) Macular edema (group II) was defined as increase in central macular thickness (CMT) by 30% compared with that before surgery. The risk factors for macular edema were evaluated. Group II was divided into two subgroups; subclinical macular edema (group II-A) and cystoid macular edema (CME, group II-B)) and they were assessed in terms of the clinical course of best corrected visual acuity (BCVA) and CMT.
A total of 376 patients were enrolled in this study, of which 36 (9.57%, group II) showed macular edema measured by OCT after the surgery. Univariate analysis for no macular edema group (group I) and group II revealed that intracameral injection of epinephrine during phacoemulsification was associated with the development of macular edema. In group II, 5 patients (1.33%) developed CME. Statistically significant differences in the clinical course of CMT were observed at 2 months (201.2 ± 23.1, 250.0 ± 29.8, and 371.0 ± 160.3 in group I, group II-A, and group II-B, respectively, P < .001) and 1 month postoperatively (198.5 ± 23.6, 237.8 ± 40.9, and 314.0 ± 104.5 in group I, group II-A, and group II-B, respectively, P < .001). Group II-B required additional treatment and eventually achieved BCVA of > 0.2 with CMT in the normal range.
The intracameral injection of epinephrine may cause macular edema after uncomplicated cataract surgery. Examination of CMT using OCT is recommended for the early detection of macular edema.