inflamation session - All India Ophthalmological Society

INFLAMMATION SESSION297that is often missed on regular clinical follow up.This complication has been recognized for over50 years and its incidence varies widely between1-2% using modern cataract extractiontechniques.OCT, an evolving ocular imaging technology israpidly finding a place in the diagnosis of CME.OCT is more sensitive than a clinical examinationin assessing macular edema and is a quantitativetool for documenting changes in macularthickness.1. To detect the incidence of CME followingmanual SICS using Stratus OCT 3.2. To quantify the macular edema followingmanual SICS using Stratus OCT 3.Materials and MethodsStudy was conducted on 100 eyes of 100 patientsof senile cataract undergoing manual SICS in ourhospital between April 2007 and March 2008.Inclusion Criteria: Patients of senile cataractundergoing manual SICS.Exclusion Criteria1. Hazy ocular media that may preclude goodclinical examination, Optical CoherenceTomography (OCT) imaging, and slit lampbiomicroscopy like Corneal opacity,Iridocyclits, Vitreous hemorrhage etc.2. Pre-existing macular pathologies like Macularhole, Macular scar, Macular edema etc.3. Any ocular inflammation.4. Any previous laser treatment of retina.5. IOP > 21 mm of Hg.Detailed history and ocular examinationincluding BCVA, IOP, slit lamp examination ofanterior segment and fundus examination using+78D lens and indirect ophthalmoscopy wasdone pre-op in each subject and a baseline OCTfast macular scan was performed to note themacular thickness in the foveal region, superior,inferior, nasal and temporal quadrants in innerand outer zones. Manual SICS was performed inthe patients with frown incision andimplantation of IOL by the same surgeon. Allpatients were given routine post-op treatmentwith oral analgesics, antibiotics and steroids for 5days and topical anti-inflamatory agents,antibiotics and steroids for 6 wks. Then repeatfast macular OCT scans were performed post opon day 1, 4 wks, 8 wks and 12 wks and the resultsstatistically analyzed.ResultsDemographic Characteristics of StudyPopulationTotal Patients 100Males 44Females 56R/E 62L/E 38Age group55yrs and abovePre-op BCVA 6/60 and worse in all patients.Pre-op mean IOP 14.6mm Hg.Table showing incidence of Macular OedemaPost-op using OCTIncidence of CME at day 1 5%Incidence of CME at 4wks 30%Incidence of CME at 8wks 32%Incidence of CME at 12wks 14%Summary1. Macular thickness was comparable pre-opand at day1 post-op.2. It increased in all patients at 4 wks and 8 wksQuadrants Baseline Pre-Op Day 1 4wks 8wks 12wksFovea 179.15±19.84 181.25±21.05 202.75±25.54 206.2±27.23 183.65±24.15Temporal inner macula 222.25±30.37 223.55±30.72 245.3±30.70 246.8±31.04 225.55±32.10Temporal outer macula 207.4±19.52 208.9±19.51 229.15±20.18 230.7±20.24 210.9±20.91Superior inner macula 252.9±25.38 254.2±25.66 275.4±26.72 277.6±27.21 256.15±26.87Superior outer macula 226.8±18.03 228.35±18.16 244.3±24.32 246.55±24.65 230.15±19.74Nasal inner macula 258.25±24.31 260.2±24.35 282.3±27.30 283.6±27.17 261.9±24.76Nasal outer macula 242.85±19.68 244.2±19.76 266.5±19.65 268.05±19.65 246.1±20.67Inferior inner macula 254.8±21.96 256.6±21.90 278.85±22.96 280.3±23.24 258.6±23.24Inferior outer macula 218.1±18.50 219.3±18.81 238.5±19.29 239.6±19.19 220.6±19.29