EXTRACAPSULAR CATARACT-EXTRACTION WITH PLACEMENT OF A POSTERIOR CHAMBER LENS IN PATIENTS WITH DIABETIC-RETINOPATHY

Purpose: The authors evaluated factors that might influence the outcom e of extracapsular cataract extraction with placement of a posterior c hamber lens in patients with diabetic retinopathy. The factors include d patient age and sex, severity of the retinopathy, preoperative laser photocoagulation, vitrectomy, and posterior capsulotomy. Methods: The records of 109 patients who had been examined by the authors before c ataract surgery were retrospectively reviewed. Results: The final visu al acuity in only 48% of the eyes was 20/40 or better, and 28% had 20/ 200 or worse visual acuity. Only 65% had an improvement in visual acui ty of two or more Snellen lines. Eyes with preoperative macular edema had a poorer visual outcome than eyes without. Macular edema and ische mia accounted for 70% of the eyes with a final visual acuity of 20/50 or worse. The authors found that age was a strong predictor of final v isual acuity and chances of improvement. In patients 63 years of age a nd younger, 58% had 20/40 or better and 81% had improved visual acuity . In patients 64 years of age and older, only 38% had 20/40 or better and only 54% were improved. Supplementary panretinal photocoagulation was required in 37% of patients who had received it preoperatively. Ne ovascularization of the iris developed in 6% of patients. Posterior ca psulotomy did not cause an increased incidence of neovascularization o f the iris or in the development or progression of proliferative retin opathy or macular edema. Conclusion: The prognosis of patients with di abetic retinopathy about to undergo cataract surgery, even extracapsul ar cataract extraction with placement of a posterior chamber lens, is guarded.