LONG-TERM PROGNOSIS OF EXTRACAPSULAR CATARACT-EXTRACTION AND INTRAOCULAR-LENS IMPLANTATION IN DIABETIC-PATIENTS

Although cataract extraction with intraocular lens implantation (IOL) is being used for increasing numbers of patients, there is still insuf ficient information regarding the long-term outcome for these patients . In this retrospective study of 140 eyes of 102 patients, 97 eyes (69 %) achieved a best visual acuity of 20/40 or better. After a minimum 6 -month postoperative period, 26 eyes (19%) had developed retinopathy: eight eyes progressed from nonproliferative to proliferative retinopat hy. Glycosylated hemoglobin levels and fasting blood glucose were sign ificantly higher at time of surgery in the eight that progressed than in those who did not (P = 0.002, P = 0.034). There were 65 unilateral IOL implantations; in 10 (15%) of these eyes, retinopathy progressed. Retinopathy also progressed in 70% of the fellow eyes of these patient s. In patients whose retinopathy did not progress, 95% of the fellow e yes also showed no progression. Also, patients with progression in the pseudophakic eye frequently had progression in the fellow unoperated eye. Postoperative progression was symmetrical (P = 0.0001). Our analy sis suggests that progression of diabetic retinopathy following IOL im plantation can be correlated to diabetic control at the time of surger y. (C) 1997 Japanese Ophthalmological Society.