Edema macular quístico pseudofáquico. Detección mediante «Optical Coherence Tomography» / Pseudophakic cystoid macular edema. Assesment with optical coherence tomography

RESUMEN

Objetivo: Detectar la incidencia de edema macularquístico (EMQ) tras cirugía de catarata tanto clínicocomo subclínico, mediante «ocular coherencetomography» (OCT) y comparar dicha incidenciaentre un grupo de pacientes diabéticos y otro de nodiabéticos.Material y métodos: Estudio prospectivo de 260ojos intervenidos de forma consecutiva de cataratamediante facoemulsificación con implante de lenteintraocular acrílica, desde septiembre de 2004 amarzo de 2005. Grupo A 208 ojos de pacientes nodiabéticos, grupo B 42 ojos de pacientes diabéticos,grupo C 10 ojos de pacientes diabéticos conedema macular y que recibieron triamcinolonaintravítrea (TAIV) al finalizar la cirugía. En cadarevisión efectuada a los 6 días (basal), 5 semanas y12 semanas se realizó biomicroscopía de polo posteriory OCT.Resultados: El espesor macular en la OCT, fue significativamentesuperior en el grupo B que en elgrupo A (241,6 versus 204,6 μm p=43,74 μm (2 DE del valor basal del grupo A). En elgrupo B, seis ojos presentaron EMQ clínicamentesignificativo, con disminución de agudeza visual(14,2%), en 12 ojos detectamos aumento del espesormacular (28,5%). Las diferencias entre gruposfueron significativas (p<0,001). En los 10 ojos querecibieron TAIV se observó una disminución mediadel espesor central de 77 μm a las 12 semanas.Conclusiones: La incidencia de EMQ clínico hasido muy baja en esta serie. La OCT detectó unaumento del espesor macular en ambos grupos enun pequeño porcentaje de pacientes y significativamentemayor en el grupo de pacientes diabéticos

ABSTRACT

Purpose: To determine the incidence of cystoid macular edema (CME) by means of clinical evaluation and subclinical assessment by means of ocular coherence tomography (OCT), and to compare the incidence between diabetic and non-diabetic groups of patients. Methods: Prospective study of 260 consecutive cataract surgeries operated from September 2004 to March 2005. The procedures were performed by means of phacoemulsification plus intraocular acrylic lens implantation. Group A 208 eyes of nondiabetic patients; Group B 42 eyes of patients with diabetes and Group C 10 eyes of diabetic patients with macular edema that received an intravitreal injection of triamcinolone at the end of surgery. Postoperative follow-up visits were performed 6 days (basal visit), 5 weeks and 12 weeks after surgery. Each visit included posterior pole biomicroscopy and OCT. Results: Central macular thickness measured by OCT was significantly increased in group B compared with group A (241.6 versus 204.6 μm; p<0,001). No clinical evidence of CME was found in group A, although 4 eyes (1.92%) showed macular thickness equal to or greater than 43.74 μm (2 standard deviations of the basal value for group A). In group B, clinical evidence of CME was found in 6 eyes, with decreased visual acuities (14.2%). The differences between these groups were statistically significant (p<0.001). The 10 eyes that received an intravitreal injection of triamcinolone after the surgical procedure showed a mean decrease in central retinal thickness of 77 μm after 12 weeks postoperative. Conclusions: This study has shown a low incidence of clinical CME. OCT showed increased macular thickness in both groups of patients in a small percentage of cases, and significantly increased macular thickness in diabetic patients