The visual results and changes in retinopathy in diabetic patients following cataract surgery

Introduction. A study was designed to investigate the visual improvement an d incidence of progression of retinopathy in diabetic patients following ex tracapsular cataract extraction or phacoemulsification. They Were compared to a matched group of non-diabetic patients. Methods. A retrospective analysis of all diabetic patients (118) undergoing ECCE (90) or phacoemulsification (28) in 1995. These patients were operati on and age matched with 118 non-diabetic patients who underwent surgery dur ing the same year. Results. There was no statistically significant difference in complications following ECCE in diabetic and non-diabetic patients (p=0.2). Complication s were however more common in non-diabetic patients undergoing phacoemulsif ication compared to diabetics undergoing the same procedure (p=0.046). Alth ough consultants performed 42% of the surgery in diabetics compared to 31% in non-diabetics, there was no significant difference in the rate of compli cations between consultants and residents (p=0.8). Overall the visual impro vement in non-diabetics was better than diabetic patients (p=0.006). This w as due to a better improvement amongst non-diabetic patients undergoing pha coemulsification (p=0.02). Overall, cataract surgery was found to lead to a worsening in retinopathy in 19 operated eyes (15 had no retinopathy preope ratively) compared to a worsening in 8 fellow eyes. This was statistically significant (p=0.04). However, ECCE was no more likely to cause worsening o f retinopathy than phacoemulsification (p=0.87). Conclusions. Diabetic patients due to undergo cataract surgery a) have a go od chance of visual improvement but to a level less than if they were not d iabetic, b) have a greater chance of visual loss, c) surgery may initiate o r worsen any pre-existing retinopathy and this may affect their vision in t he future.