Quantification of macular and optic disc hyperfluorescence after phacoemulsification in diabetes mellitus

To quantify changes in areas of hyperfluorescence of the macula, perifovea, and optic disc after phacoemulsification in patients with diabetes mellitus and evaluate relationships between hyperfluorescence, macular thickness, diabetic retinopathy (DR), and logMAR best corrected visual acuity (BCVA).

Ophthalmology Clinic and Operating Room, Ambulatory Care Center, University of North Carolina at Chapel Hill, School of Medicine, and the University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.

This prospective case-control study comprised 30 eyes of 24 subjects with cataracts and diabetes mellitus with different levels of DR. Preoperatively and 2 months postoperatively, BCVA was recorded, digital retinal photography and fluorescein angiography were performed, macular thickness was measured (optical coherence tomography), and DR and hyperfluorescence of the optic disc, macula, and perifovea were quantified.

Postoperatively, BCVA improved in surgical eyes but was unchanged in nonsurgical eyes. Preoperatively, between eyes, there was no difference in hyperfluorescence. Postoperatively, hyperfluorescence of the optic disc, macula, and perifovea increased in surgical eyes and was unchanged in nonsurgical eyes. Macular thickness increased in surgical eyes, although DR was unchanged in surgical and nonsurgical eyes. Although there was no correlation between hyperfluorescence and macular thickness in surgical eyes, increased hyperfluorescence of the perifovea was associated with less improvement in BCVA.

After phacoemulsification, hyperfluorescence and macular thickness increased in the eyes of diabetic subjects. These short-term changes are more likely an effect of the surgery than a worsening of DR.