Incidence of cystoid macular oedema in diabetic patients after phacoemulsification and free radical link to its pathogenesis.
OBJECTIVE
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.
Department of Ophthalmology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India School of Biotechnology, KIIT University, Bhubaneswar, India.
Anupam
A
Samanta
School of Biotechnology, KIIT University, Bhubaneswar, India.
Premranjan
P
Kumar
School of Biotechnology, KIIT University, Bhubaneswar, India.
Sanghamitra
S
Machhua
Department of Ophthalmology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India.
G Nageswar
GN
Rao
School of Biotechnology, KIIT University, Bhubaneswar, India.
Arttatrana
A
Pal
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005609:Free Radicals / Q000378:metabolism*; D006801:Humans; D008269:Macular Edema / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000097:blood; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology
D000975:Antioxidants; D015415:Biomarkers; D005609:Free Radicals; D017382:Reactive Oxygen Species
Biochemistry; Pathology; Public health; Treatment Surgery; Visual perception