A study to assess the macular thickness and visual outcome before and after cataract surgery


  • Abhishek Salwan Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Sri Amritsar, Punjab
  • Shakeen Singh Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Sri Amritsar, Punjab




PHACO, SICS, OCT, Macular thickness, CME


Background: Cystoid macular edema (CME) is the formation of fluid-filled cystoid spaces between the outer plexiform and inner nuclear layers of the retina. It may present as a complication of routine cataract surgery including phacoemulsification (PHACO) and small incision cataract surgery (SICS).

Methods: An observational study of uncomplicated cataract surgery with assessment by ophthalmoscopy, slit Lamp, Snellen chart and OCT during pre- and post-operative period. 100 patients were selected by inclusion criteria and using convenient sampling technique and were divided into two groups of 50 each in PHACO and SICS groups.

Results: During preoperative observation in SICS/group-1, mean value and SD of macular thickness was 223.38±12.61 and in PHACO/group-2 it was 224.14±12.69. Mean value, mean difference and p value of visual acuity in group 1 was 0.258, during 12 weeks 0.788 with mean difference -0.53 and p=0.000 and in group 2 it was 0.269, during 12 weeks 0.844 with mean difference -0.58 and p=0.000. Mean value, SD, mean difference and p value of macular thickness in SICS during 1 week was 238.28±12.29, during 12 weeks 227.04±12.58 with mean difference 11.24000 and p=0.000 and in PHACO mean value, SD, mean difference with p value during 1 week was 231.90±12.42, during 12 weeks was 225.02±11.74 with mean difference 6.88000 and p=0.000.

Conclusions: A subclinical increase in post-operative macular thickness was recorded which returned nearly to baseline values during the 12 weeks follow up and did not affect visual outcome.


Bowling B. Kanski’s clinical ophthalmology: A systematic approach. 8th ed. London, England: WB Saunders. 2015;630-1.

Byrnes GA, Antoszyk AN, Mazur DO, Kao TC, Miller SA. photic maculopathy after extracapsular cataract surgery-a prospective study. Ophthalmology. 1992;99(5):731-7.

Ichhpujani P. Expert Techniques in Ophthalmic Surgery 1st ed. Jaypee Brothers Medical Publishers. 2015;5.

Mentes J, Erakgun T, Afrashi F, Kerci G. incidence of cystoid macular edema after uncomplicated phacoemulsification. Ophthalmologica. 2003;217(6):408-12.

Khanna R, Pujari S, Sangwan V. Cataract surgery in developing countries. Curr Opin Ophthalmol. 2011;22(1):10-4.

Gogate PM, Kulkarni SR, Krishnaiah S, Deshpande RD, Joshi Sa DMD. safety and efficacy of phacoemulsification compared with manual small incision cataract surgery by a randomized control clinic trail: six-week result. Ophthalmology. 2005;112:869-74.

Samuel Boyd R, Brancato BS. Optical coherence tomography-Atlas and text 1st ed; Jaypee-Highlights Medical Publishers. 2009;1-11.

Hee MR, Puliafito CA. Wong C. Quantitative assessment of macular edema with OCT. Arch Ophthalmol. 1998;105:360-70.

Boyd S. Optical coherence tomography-Atlas and text, 1st Ed, Published by Jaypee-Highlights Medical Publishers, Inc. 2000;1-11.

Danis RP, Fisher MR, Lambert E, Goulding A, Wu D, Lee LY. Results and repeatability of retinal thickness measurement from certificate submissions. Arch Ophthalmol. 2008;126(1):45-50.

Garg A, Alio JL. Surgical. Tech Ophthalmol 1st ed. 2010:65-75, 205-210.

Yanoff M, Duker’s J. Ophthalmology, 5th ed. Elsevier Publications. 2019;626-31.

Miyake K, Ibaraki N. prostaglandins and cystoid macular edema. Surv Ophthalmol. 2002;47(1):S203-18.

Garcia-Martin E, Fernandez J, Gil-Arribas L, Polo V, Larrosa JM, Otin S et al. Effect of cataract surgery on optical coherence tomography measurements and repeatability in patients with non-insulin-dependent diabetes mellitus. Invest Ophthalmol Vis Sci. 2013;54(8):5303-12.

Gharbiya M, Cruciani F, Cuozzo G, Parisi F, Russo P, Abdolrahimzadeh S. Macular thickness changes evaluated with spectral domain optical coherence tomography after uncomplicated phacoemulsification. Eye (Lond). 2013;27(5):605-11.

Abd El-Mawgoud SM, Arfeen SAS, El-Gendy NS, Fathy AM. National Eye Center, Cairo, Egypt, Delta. J Ophthalmol Year. 2018;19(2):106-10.

Wang Y, Du J, Yang M, Xu Y, Guan H, Wu J. Distinct macular thickness changes after femtosecond laser-assisted cataract surgery of age-related cataract and myopia with cataract. Sci Rep. 2018;8(1):3279.






Original Research Articles