Retinopathy progression and visual outcomes after phacoemulsification in patients with diabetes mellitus

Objectives: To determine the rate of progression of diabetic retinopathy af ter phacoemulsification surgery, and whether surgeon experience and/or surg ical duration adversely affect visual outcome. Methods: A retrospective review of 150 eyes of 119 diabetic patients who un derwent phacoemulsification surgery, during a 5-year period was performed. Data collected included patient age, sex, type and duration of diabetes, di abetic control, associated systemic health factors, preoperative visual acu ity and retinopathy grade, duration of surgery, intraoperative complication s, and postoperative course. The effect of these factors on visual outcome and rate of retinopathy progression was studied by means of univariate and stepwise multivariate logistic regression analyses. Resident and private ca ses were compared. Results: Visual acuity improved by 2 or more lines in 117 eyes (78%); 93 ey es (62%) had a final visual acuity of at least 20/40. Retinopathy progressi on was seen in 37 eyes (25%) with 6 to 10 months of follow-up. Preoperative nonproliferative diabetic retinopathy, proliferative diabetic retinopathy, and limited surgical experience were statistically associated with retinop athy progression and poor visual outcome. Conclusions: The visual results and rate of retinopathy progression after p hacoemulsification surgery in our series did not differ significantly from those reported that used other techniques. Nonproliferative and proliferati ve diabetic retinopathy and surgical inexperience resulted in an increased rate of retinopathy progression.