INFLUENCE OF CATARACT-SURGERY ON THE DIABETIC EYE - A PROSPECTIVE-STUDY

The course of diabetic retinopathy following phacoemulsification and i n-the-bag implantation of an intraocular lens (IOL) was studied prospe ctively in 223 patients (223 eyes). A total of 205 eyes were followed for 6 months. The nonoperated fellow eyes served as a control group. A t the time of surgery, 158 patients had no diabetic retinopathy, 45 sh owed untreated background retinopathy, and 20 had more serious retinop athy with previous coagulation therapy. At 6 months of follow-up, 18.4 % of the operated eyes without preoperative retinopathy developed back ground retinopathy, as did 14.3% of the untreated fellow eyes. Worseni ng of preexisting diabetic retinopathy during the observation period o ccurred in 27.6% of the operated eyes and in 29.3% of the non-operated eyes. Although the final visual acuity achieved in our patients was p oorer than that reported for nondiabetics, our functional results were satisfying: 94.1% of the operated eyes showed improved visual acuity 6 months postoperatively, 2.4% deteriorated, and 3.4% were unchanged. We therefore conclude that cataract surgery in diabetic patients can b e performed with an acceptable risk of complications. Furthermore, wor sening of diabetic retinopathy seems to be correlated not with the cat aract surgery but with the natural course of diabetic vascular disease .