Dr.Prajakta Paritekar

1. Dr.Prajakta Paritekar

2. AIM
• To compare incidence of post-operative
clinical CME after uneventful SICS in Diabetics
and Non-Diabetics.

3. MATERIALS AND METHODS
• Prospective longitudinal study.
• Total 150 patients- Two groups:
1) 30 patients- Diabetic
2) 120 patients- Non Diabetic
• All patients underwent detailed evaluation of
anterior and posterior segment.
• They were then posted for Small Incision
Cataract Surgery.

4. • Post-operative follow up was done on day 1, 7,
30, 40, 60, 80.
• If drop in visual acuity was noted then detailed
fundus evaluation was done.
• Patients who were clinical suspects of CME
were advised OCT for confirmation of
diagnosis.
• After confirming the diagnosis, retroseptal
4mg Inj.Kenacort was given.
• Patients were followed up subsequently.

5. • Data was entered in Microsoft Excel and was
analyzed using Stata Version 13.
• We calculated the means and standard deviations for
the linear variables, and proportions for the
categorical variables.
• The means between two groups were compared
using the unpaired t-test (for different groups).
• The proportions were compared using the chi square
test or the Fisher’s exact test (for low expected cell
counts).
• We used the Mann-Whitney test for comparing the
distribution of two populations and the Wilcoxon
matched-pairs signed-ranks test for equality of
matched pairs.

6. INCLUSION CRITERIA
• Otherwise healthy patients (non-diabetics)
• No history of any other ocular procedure in the
past.
• Having any grade of cataract according to LOCS
classification and whose fundus examination is
possible.
• Willing to come for follow up.
• Well controlled Diabetic patients (HbA1C levels
</= 7mg/dl).

7. EXCLUSION CRITERIA
• Failure to follow up.
• Patients who develop intra-operative
complications.
• Patients having hazy media that obscure
fundus examination.
• Prolonged duration of surgery – more than
30min.

8. 0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
6.00%
7.00%
8.00%
DIABETIC NON-DIABETIC
INCIDENCE OF CME
INCIDENCE OF CME
6.67%
1.67%

9. CONCLUSION
• Incidence of CME following uneventful manual
SICS is more in Diabetic patients than in Non-
Diabetic patients.
• Older patients are more at risk to develop
pseudophakic CME.
• Diabetic patients show more aggressive
course of CME than Non-Diabetics.
• Peak Incidence of CME is 4-6 weeks.
• Diabetics present earlier than Non-Diabetic.

10. DISCUSSION
• Vision is one of the most important special
senses that a living being possesses.
• Pseudophakic cystoid macular edema (CME) is
one of the complications that can occur
following cataract surgery.
• Literature shows that incidence of clinical CME
following manual small incision cataract
surgery is 2% (1) and that following
phacoemulsification is 0-2%.(2)

11. • We also know that incidence of CME is
influenced by various factors like intra-
operative complications such as posterior
capsule tear, vitreous loss and post-operative
complications like iritis.
• Postoperative CME represents a well-known
distinct entity – Irvine Gass Syndrome.(3)
• It was first reported by A. Ray Irvine Jr. and
later elucidated with fluorescein angiography
by J. Donald M. Gass

12. REFERENCES
1. Daxa N Sharma. Prospective study of incidence of cystoid macular
edema in uneventful cataract surgery: a study of 100 cases. Int J Med Sci
Public Health. (2015), [cited October 28, 2015]; 4(11): 1561- 1564.
2. Miltiadis K Tsilimbaris, Chrysanthi Tsika, Vasilios Diakonis, Aleksandra
Karavitaki and Ioannis Pallikaris (2013). Macular Edema and Cataract
Surgery, Cataract Surgery, Dr. Farhan Zaidi (Ed.), ISBN: 978-953-51-0975-
4, InTech, DOI: 10.5772/22479.
3. Yonekawa Y, Kim IK. Psedophakic cystoid macular edema.Curr
Ophthalmol 2012 Jan; 23(1):26-32.