S A Sadiq1, T Sleep, W M Amoaku. 1. Department of Ophthalmology, Queen's Medical Centre, Nottingham, U.K.
Abstract
INTRODUCTION: A study was designed to investigate the visual improvement and incidence of progression of retinopathy in diabetic patients following extracapsular cataract extraction or phacoemulsification. They were compared to a matched group of non-diabetic patients. METHODS: A retrospective analysis of all diabetic patients (118) undergoing ECCE (90) or phacoemulsification (28) in 1995. These patients were operation and age matched with 118 non-diabetic patients who underwent surgery during the same year. RESULTS: There was no statistically significant difference in complications following ECCE in diabetic and non-diabetic patients (p = 0.2). Complications were however more common in non-diabetic patients undergoing phacoemulsification compared to diabetics undergoing the same procedure (p = 0.046). Although consultants performed 42% of the surgery in diabetics compared to 31% in non-diabetics, there was no significant difference in the rate of complications between consultants and residents (p = 0.8). Overall the visual improvement in non-diabetics was better than diabetic patients (p = 0.006). This was due to a better improvement amongst non-diabetic patients undergoing phacoemulsification (p = 0.02). Overall, cataract surgery was found to lead to a worsening in retinopathy in 19 operated eyes (15 had no retinopathy preoperatively) compared to a worsening in 8 fellow eyes. This was statistically significant (p = 0.04). However, ECCE was no more likely to cause worsening of retinopathy than phacoemulsification (p = 0.87). CONCLUSIONS: Diabetic patients due to undergo cataract surgery a) have a good chance of visual improvement but to a level less than if they were not diabetic, b) have a greater chance of visual loss, c) surgery may initiate or worsen any pre-existing retinopathy and this may affect their vision in the future.
INTRODUCTION: A study was designed to investigate the visual improvement and incidence of progression of retinopathy in diabeticpatients following extracapsular cataract extraction or phacoemulsification. They were compared to a matched group of non-diabeticpatients. METHODS: A retrospective analysis of all diabeticpatients (118) undergoing ECCE (90) or phacoemulsification (28) in 1995. These patients were operation and age matched with 118 non-diabeticpatients who underwent surgery during the same year. RESULTS: There was no statistically significant difference in complications following ECCE in diabetic and non-diabeticpatients (p = 0.2). Complications were however more common in non-diabeticpatients undergoing phacoemulsification compared to diabetics undergoing the same procedure (p = 0.046). Although consultants performed 42% of the surgery in diabetics compared to 31% in non-diabetics, there was no significant difference in the rate of complications between consultants and residents (p = 0.8). Overall the visual improvement in non-diabetics was better than diabeticpatients (p = 0.006). This was due to a better improvement amongst non-diabeticpatients undergoing phacoemulsification (p = 0.02). Overall, cataract surgery was found to lead to a worsening in retinopathy in 19 operated eyes (15 had no retinopathy preoperatively) compared to a worsening in 8 fellow eyes. This was statistically significant (p = 0.04). However, ECCE was no more likely to cause worsening of retinopathy than phacoemulsification (p = 0.87). CONCLUSIONS:Diabeticpatients due to undergo cataract surgery a) have a good chance of visual improvement but to a level less than if they were not diabetic, b) have a greater chance of visual loss, c) surgery may initiate or worsen any pre-existing retinopathy and this may affect their vision in the future.
Authors: Y Yang; C Bailey; F G Holz; N Eter; M Weber; C Baker; S Kiss; U Menchini; J M Ruiz Moreno; P Dugel; A Lotery Journal: Eye (Lond) Date: 2015-06-26 Impact factor: 3.775