STRUCTURAL AND FUNCTIONAL MACULAR CHANGES AFTER CATARACT SURGERY IN DIABETIC PATIENTS/STRUKTURALNE I FUNKCIONALNE PROMENEMAKULE NAKON OPERACIJE KATARAKTE KOD PACIJENATA OBOLELIH OD DIJABETESA

Introduction. In recent years, the number of diabetic patients requiring cataract surgery has been on the rise. The aim of this study was to examine the effects of cataract surgery on visual acuity and changes in the central retinal thickness in diabetic patients with and without retinopathy, in relation to the duration of the disease, type of therapy, and the level of glycated hemoglobin and serum lipids. Material and Methods. The prospective study included 51 eyes of 34 patients divided into three groups. Preoperatively, all patients underwent best-corrected visual acuity evaluation with Snellen chart, cataract grading using lens opacities classification system III, as well as fundus examination and optical coherence tomography. Postoperative follow-up visits were scheduled after the first, fourth, sixth, eighth, and twelfth weeks after which the patients underwent best-corrected visual acuity evaluation and optical coherence tomography. The obtained values were statistically processed and analyzed in relation to the duration of the disease, the type of therapy, and the level of glycated hemoglobin and serum lipids. Results. Of 51 eyes, 5.9% developed macular edema during the fourth postoperative week with central retinal thickness > 310 [micro]m. Subclinical central retinal thickness changes were registered in all groups with the highest values in group I (diabetics with retinopathy) in the sixth postoperative week. The average value of central retinal thickness in group I was 256 [+ or -] 11 [micro]m at baseline and 273 [+ or -] 11 [micro]m in week 6. The best-corrected visual acuity improved in all groups, without changes in central retinal thickness. Conclusion. Good visual acuity and absence of significant changes in macular thickness are helpful when making the decision to perform cataract surgery in patients with diabetes. Postoperative follow-up visits should include optical coherence tomography in addition to standard procedures. Key words: Cataract; Macular Edema; Diabetes Complications; Cataract Extraction; Diabetic Retinopathy; Tomography, Optical Coherence; Visual Acuity; Glycated Hemoglobin A Uvod. Danas se sve veci broj pacijenata koji imaju dijabetes melitus javljaju se na operaciju katarakte. Cilj ovog istrazivanja bio je ispitivanje uticaja operacije katarakte na vidnu ostrinu i promene centralne retinalne debljine kod dijabeticara u odnosu na duzinu trajanja oboljenja, vrstu terapije dijabetesa, visinu glikoziliranog hemoglobina i seru