Impact of uncomplicated cataract surgery on central retinal thickness changes in diabetic patients: A short-term analysis

Abstract Purpose To evaluate short-term changes in central retinal thickness (CRT) after uncomplicated cataract surgery in diabetic patients and assess the influence of diabetic retinopathy severity on postoperative retinal response. Methods This prospective, observational study included 102 eyes of 102 type 2 diabetic patients undergoing cataract surgery at a single tertiary center. Patients were divided into two groups: Group I (n = 51) without diabetic retinopathy and Group II (n = 51) with diabetic retinopathy. CRT was assessed using spectral-domain optical coherence tomography (SD-OCT) at baseline and postoperatively at weeks 1, 6, and 12. Changes in CRT ≥ 10 µm, ≥ 29 µm, and ≥ 50 µm were analyzed. Associations with systemic parameters such as duration of diabetes and HbA1c were also evaluated. Results CRT significantly increased from baseline in both groups, peaking at 6 weeks postoperatively (Group I: median 263 µm; Group II: median 270 µm; p = 0.001). At 6 weeks, 27.5% of Group I and 74.5% of Group II patients developed CRT increases ≥ 10 µm (p < 0.001), with 21.6% of Group II showing increases ≥ 29 µm and 7.8% ≥50 µm. No significant differences in best corrected visual acuity (BCVA) loss were observed between groups (p = 0.265). Among Group II, CRT elevation was greatest in patients with more severe stage of diabetic retinopathy. Higher HbA1c and longer diabetes duration correlated positively with CRT increase at week 6 (r = 0.318 and r = 0.201, respectively). Conclusion Subclinical CRT changes were observed after the cataract surgery in diabetic patients, particularly in those with existing diabetic retinopathy (DR). The severity of DR correlates with the magnitude of retinal thickening, peaking at 6 weeks. Despite CRT elevation, visual acuity remained stable in the short term. Duration of diabetes and elevated HbA1c were identified as systemic risk factors. These findings underscore the importance of OCT monitoring and DR staging in perioperative diabetic care.