Ja. West et al., Panretinal photocoagulation during cataract extraction in eyes with activeproliferative diabetic eye disease, EYE, 13, 1999, pp. 170-173
Purpose Cataract surgery in the presence of active proliferative diabetic e
ye disease carries a high risk of progression of retinopathy and neovascula
r glaucoma. Lens opacities may prevent panretinal photocoagulation (PRP) be
fore surgery, and applying PRP in the immediate post-operative period can b
e difficult. The purpose of this study is to report results of cataract ext
raction combined with per-operative indirect laser PRP in a group of these
patients.
Methods Nine eyes of 9 diabetic patients with active retinal or iris neovas
cularisation in which lens opacities prevented adequate preoperative PRP un
derwent cataract surgery combined with indirect laser PRP after cortex aspi
ration and before intraocular lens implantation.
Results Regression of neovascularisation with this combined procedure alone
was achieved in 5 eyes, 3 responded to further PRP, and 1 developed neovas
cular glaucoma. Visual acuity improved in all eyes, 4 achieving greater tha
n or equal to 6/12. Four patients developed increased postoperative uveitis
. One developed clinically significant macular oedema.
Conclusions The method described has definite practical advantages over PRP
attempted in the immediate post-operative period, when many factors can pr
event its application or reduce its effectiveness, and when neovascularisat
ion may be progressing rapidly. In addition, adjunctive per-operative indir
ect laser PRP appears to improve the outcome of cataract surgery in eyes wi
th active proliferative diabetic eye disease.