Outcome of cataract surgery in diabetic patients

Introduction. The association between diabetes and cataract formation has been shown in many clinical studies. Development of cataract occurs more frequently and at an earlier age in diabetic patients. Due to the increasing prevalence of diabetes worldwide, the incidence of diabetic cataracts steadily rises. While the overall outcomes of cataract surgery are excellent, patients with diabetes may have poorer vision outcomes than those without diabetes. The objective of this study was to evaluate the visual outcomes (visual acuity and visual function), intraoperative and postoperative complications of cataract surgery, and to assess the final surgical outcomes. Material and Methods. The prospective study included 128 patients (133 eyes) with cataract and diagnosis of diabetes mellitus type 2 at least 5 years prior to cataract surgery, operated at the Eye Clinic, Clinical Center of Vojvodina, Novi Sad. A full medical history included patients' age, the time since the diagnosis of diabetes, current management of diabetes, blood pressure and assessment of glycemic control using glycosylated hemoglobin. All patients underwent complete ophthalmological examination before cataract surgery, and were re-examined 7 days, one and six months after the surgery. Results. The mean age of patients at the time of surgery was 63.5 years (SD ± 6.5, range 57 - 70 years) with mean duration of diabetes 8.5 years. The glycosylated haemoglobin level in the group treated with insulin was 6.8 vs. 8.2 in patients on oral medications (p < 0.05). Diabetes mellitus was accompanied by other systemic diseases in 81 patients (63.28%), whereas 45 of 133 operated eyes (33.83%) had other ocular diseases. Intraoperative complications occurred in 20 of 133 operated eyes (15%): posterior capsular rupture with vitreous loss, intraoperative miosis, iris hemorrhage and suprachoroidal hemorrhage. Conclusion. Cataract surgery with intraocular lens implantation is an effective and safe surgical procedure in diabetic patients, and sight threatening complications are rare. Our study confirmed that visual acuity after surgery in diabetic patients depends on the severity of diabetic retinopathy at the time of surgery.