EJMS

Abstract

Purpose: To compare the macular thickness changes and visual outcomes after Nd:YAG laser capsulotomy in diabetic and non-diabetic patients. Patients and methods: This interventional comparative study recruited diabetic and non-diabetic patients with visually significant posterior capsular opacification (PCO) who underwent uncomplicated cataract surgery with intraocular lens (IOL) implantation. Baseline ophthalmic evaluation was performed, including spectral-domain optical coherence tomography (SD-OCT), and all candidates had Nd:YAG laser capsulotomy. Outcome measures were the mean changes in central macular thickness by SD-OCT and best-corrected visual acuity (BCVA) in 1 week, 4 weeks, and 12 weeks after treatment. Results: The study recruited 60 patients; 30 diabetic and 30 non-diabetic patients who had Nd: YAG laser posterior capsulotomy. BCVA was significantly better in non-diabetic patients at 1 week than diabetics (LogMAR 0.19±0.05 versus 0.25±0.09 respectively, p < 0.05) with insignificant difference between the 2 groups at 4 and 12 weeks (p = 0.208, and 0.286 respectively). As regard changes in CMT, diabetic patients showed a significant increase in thickness at 1 week (313.9±8.8 um, p < 0.05), which was higher than non-diabetic patients (302.1±6.7, p < 0.05). Afterward, there was a significant reduction of CMT in both groups at 4 weeks and 12 weeks post-YAG laser. Only one diabetic patient developed cystoid macular edema after 12 weeks and needed intravitreal anti-VEGF. Conclusion: Though Nd: YAG laser capsulotomy is a safe and effective procedure for the management of PCO, it may influence CMT among diabetic than non-diabetic patients.