Reeta Danni1, Claudia Taipale1, Lotta Ilveskoski1, Raimo Tuuminen2. 1. Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland. 2. Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland; Unit of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland. Electronic address: raimo.tuuminen@helsinki.fi.
Abstract
PURPOSE: To study the outcomes of uneventful cataract surgery in diabetic patients without retinal complications. DESIGN: A post hoc treatment analysis using data from 2 double-masked randomized clinical trials. METHODS: Setting: Conducted at Kymenlaakso Central Hospital, Kotka, Finland. PROCEDURE: A total of 276 eyes of 266 patients undergoing routine cataract surgery were included in the study. Patients with type I or II diabetes (n = 56 eyes) were compared to nondiabetic patients (n = 220 eyes). Clinical evaluation was conducted by the operating physician, and outcome measures taken before surgery and day 28 were recorded by a research technician. RESULTS: Patient age, sex distribution, and all baseline ophthalmic and surgical parameters were comparable for the nondiabetic and diabetic patient groups. Increase in aqueous flare 6.3 ± 16.4 photon units (pu)/ms vs 3.7 ± 8.9 pu/ms (mean ± standard deviation; P = .282), central retinal thickness (CRT) 12.0 ± 38.2 μm vs 5.9 ± 15.8 μm (P = .256), corrected distance visual acuity 0.57 ± 0.31 decimals vs 0.53 ± 0.35 decimals (P = .259), and patient satisfaction 9.3 ± 0.9 vs 9.2 ± 1.1 (P = .644) were comparable for nondiabetic and diabetic patients. In eyes with steroid monotherapy (n = 64), CRT increased 38.1 ± 72.8 μm in nondiabetic patients compared to 7.8 ± 6.6 μm in diabetic ones (P = .010). In eyes with nonsteroidal anti-inflammatory drug (NSAID) monotherapy (n = 157), CRT increased 5.7 ± 18.4 μm in nondiabetic patients compared to 6.2 ± 20.5 μm in diabetic ones (P = .897). Among eyes with steroid and NSAID combination therapy (n = 55), CRT increased 3.6 ± 4.1 μm in nondiabetic patients compared to 2.9 ± 3.2 μm in diabetic ones (P = .606). At 28 days postsurgery, pseudophakic cystoid macular edema (PCME) was reported in 8 eyes, of which 7 were in nondiabetic patients (P = 1.000). CONCLUSIONS:Diabetic patients showed less change in CRT when compared to controls in steroid monotherapy. Other outcome measurements shows no statistical differences.
RCT Entities:
PURPOSE: To study the outcomes of uneventful cataract surgery in diabeticpatients without retinal complications. DESIGN: A post hoc treatment analysis using data from 2 double-masked randomized clinical trials. METHODS: Setting: Conducted at Kymenlaakso Central Hospital, Kotka, Finland. PROCEDURE: A total of 276 eyes of 266 patients undergoing routine cataract surgery were included in the study. Patients with type I or II diabetes (n = 56 eyes) were compared to nondiabeticpatients (n = 220 eyes). Clinical evaluation was conducted by the operating physician, and outcome measures taken before surgery and day 28 were recorded by a research technician. RESULTS:Patient age, sex distribution, and all baseline ophthalmic and surgical parameters were comparable for the nondiabetic and diabeticpatient groups. Increase in aqueous flare 6.3 ± 16.4 photon units (pu)/ms vs 3.7 ± 8.9 pu/ms (mean ± standard deviation; P = .282), central retinal thickness (CRT) 12.0 ± 38.2 μm vs 5.9 ± 15.8 μm (P = .256), corrected distance visual acuity 0.57 ± 0.31 decimals vs 0.53 ± 0.35 decimals (P = .259), and patient satisfaction 9.3 ± 0.9 vs 9.2 ± 1.1 (P = .644) were comparable for nondiabetic and diabeticpatients. In eyes with steroid monotherapy (n = 64), CRT increased 38.1 ± 72.8 μm in nondiabeticpatients compared to 7.8 ± 6.6 μm in diabetic ones (P = .010). In eyes with nonsteroidal anti-inflammatory drug (NSAID) monotherapy (n = 157), CRT increased 5.7 ± 18.4 μm in nondiabeticpatients compared to 6.2 ± 20.5 μm in diabetic ones (P = .897). Among eyes with steroid and NSAID combination therapy (n = 55), CRT increased 3.6 ± 4.1 μm in nondiabeticpatients compared to 2.9 ± 3.2 μm in diabetic ones (P = .606). At 28 days postsurgery, pseudophakic cystoid macular edema (PCME) was reported in 8 eyes, of which 7 were in nondiabeticpatients (P = 1.000). CONCLUSIONS:Diabeticpatients showed less change in CRT when compared to controls in steroid monotherapy. Other outcome measurements shows no statistical differences.
Authors: C J Doncel-Fernández; M L Alferez-Asenjo; A Quereda-Castañeda; G Castro-Luna Journal: Graefes Arch Clin Exp Ophthalmol Date: 2020-08-11 Impact factor: 3.117