Can Cataract Surgery Worsen Diabetic Retinopathy?
August 5, 2009
A study published in the August issue of Ophthalmology reported that patients with diabetes who undergo phacoemulsification surgery have a doubling in the rate of progression of diabetic retinopathy. However, this rate is still less than the rate of progression observed in patients who underwent older forms of cataract surgery.
The clinic based cohort consisted of 1994 patients 65 years and older who underwent cataract surgery between 2004 and 2006. The authors obtained digital retinal photography preoperatively and at 1, 6, and 12 months. The odds ratios and confidence intervals were calculated for the pseudophakic eyes compared with the phakic eyes with adjustments for age, sex, diabetes duration, and preoperative glycosylated hemoglobin levels.
Of the patients recruited, 190 patients had diabetes and complete data and 56 of these patients had previously undergone cataract surgery in one eye. In these 56 pseudophakic eyes, the prevalence of DR was higher than in 324 phakic eyes at baseline in the study. Of the 190 patients, 169 were followed for 12 months postoperatively; 278 eyes had undergone cataract surgery and 60 eyes retained the natural lens at 12 months. DR developed in 28.2% of pseudophakic eyes compared with 13.8% of phakic eyes.
The authors suggest that patients with diabetes and cataracts may be at higher risk of developing diabetic retinopathy. Patients with diabetes who require cataract surgery should be closely monitored and perhaps may need more preoperative precautions such as laser.
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