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Abstract

Background: Cataract is a leading cause of reversible blindness, and its coexistence with diabetes mellitus poses challenges in post-operative recovery due to the risk of macular edema. Optical coherence tomography (OCT) has emerged as a valuable tool to evaluate subtle retinal changes.
Objective: This study aims to assess and compare the macular thickness changes following phacoemulsification in type 2 diabetic and non-diabetic cataract patients, and to correlate these changes with glycemic control.
Methods: A prospective case-control study was conducted over 18 months at a tertiary care center involving 180 patients, equally divided into diabetic and non-diabetic groups. Preoperative and postoperative macular thickness measurements were performed using OCT at baseline, 1 week, 4 weeks, and 12 weeks after phacoemulsification. Blood sugar profiles, including HbA1c, were evaluated. Statistical analyses was conducted to assess correlations between glycemic control and macular changes.
Results: While preoperative macular parameters were similar between the two groups, diabetic patients demonstrated significantly higher central macular thickness and macular cube volume at 1 week post-surgery (p<0.05). Poorly controlled diabetics (HbA1c ≥6.5%) exhibited greater macular thickening compared to those with better glycemic control. However, by 12 weeks, differences in macular thickness between groups were statistically non-significant.
Conclusion: Diabetic patients, especially those with poor glycemic control, are at increased risk for early postoperative macular thicknesschanges following phacoemulsification. OCT monitoring and optimal blood sugar control are help to ensure favorable visual outcomes in these patients