Indian Journal of Clinical and Experimental Ophthalmology 2020;6(1):108–113 Content available at: iponlinejournal.com Indian Journal of Clinical and Experimental Ophthalmology Journal homepage: www.innovativepublication.com Original Research Article To study correlation of HbA1c and macular thickness changes in diabetic patients after phacoemulsification and small incision cataract surgery (SICS) Avani Soni 1 , Rajni Sethia 1, *, Parin Mehta 2 , Zeel Patel 1 , Aneesha Vyas 1 1 Dept. of Ophthalmology, SBKS MI & RC, Sumandeep Vidyapeeth, Vadodara, Gujarat, India 2 Narayana Nethralaya, Bengaluru, Karnataka, India ARTICLE INFO Article history: Received 08-01-2020 Accepted 13-01-2020 Available online 17-03-2020 Keywords: OCT Diabetics HbA1c Phacoemulsification SICS ABSTRACT Purpose: To study the relationship between HbA1c and macular thickness using Optical coherence tomography (OCT) in phacoemulsification and SICS. Materials and Methods: Retrospective study where 100 eyes of type 2 Diabetes mellitus patients with mild to moderate Non-Proliferative Diabetic Retinopathy (NPDR) were included. 50 PATIENTS underwent uncomplicated phacoemulsification surgery AND REST 50 FOR SICS and were divided into 3 groups based on HbA1c levels – Group 1: <6.5%, Group 2: 6.5%–8% and group 3: >8%. Nine macular subfields as defined by Early Treatment of Diabetic Retinopathy study (ETDRS) were measured using OCT. The HbA1c level of each patient was measured and compared with the macular thickness as well as visual acuity. Result: The macular thickness was found to be significantly higher postoperatively in SICS group (251.54 ± 22.69 μ m) than the PHACO group (230.44 ± 26.47 μ m) on post-operative day 7 and it further increased to (267.46 ± 43.44 μ m) in SICS group as compared to phaco group (244.50 ± 37.30 μ m)on postoperative 1 month in group C. CMT was highest if HbA1C levels were more than 8% as compared to other two groups on all post-operative day. No significant difference was found in BCVA between both the groups on 1 month and 3 months post- operatively. Conclusion: This study shows that cataract surgery increases the macular thickness and these increases are significantly higher in the SICS than in PHACO eyes on the POD 7, 1 month and 3 months after surgery, especially if HbA1c levels are more than 6.5%, which resolves to near normal levels in phaco group by POD 3 months. This indicates that phacoemulsification is more preferable surgery then SICS in adults with regard to postoperative increase in macular thickness. Also good control of HbA1c levels significantly decreases post-operative visual problems. © 2020 Published by Innovative Publication. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by/4.0/) 1. Introduction Diabetes mellitus (DM) is well-known for causing multiple organ damage and life-threatening outcomes due to abnormal small vessel formation. Diabetic retinopathy (DR) is one of the manifestations of chronic diabetes causing leakage and neovascularization. 1 Since many decades, the diagnos is of DM is based on either fasting plasma glucose levels or 2 hours postprandial glucose levels. It was * Corresponding author. E-mail address: avanisoni007@gmail.com (R. Sethia). only in 2010 that plasma glycosylated haemoglobin or HbA1c ≥ 6.5% was accepted by the American Diabetes Association as cut-off for DM an this modality helps to evaluate the glycosylated Hb over the past 3 months. It is now proved that HbA1c levels are better predicators of DR than any other routinely employed tests. DR can manifest in multiple forms as retinal haemorrhages, ischemia, neovascularization, and macular edema especially with poorly controlled HbA1c levels and long standing DM. 2 Out of these, macular edema is the most important predictor of poor visual outcome in diabetics, particularly https://doi.org/10.18231/j.ijceo.2020.024 2395-1443/© 2020 Innovative Publication, All rights reserved. 108