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Cataract extraction rate after vitrectomy lower in patients with diabetes
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Patients with diabetes have a lower rate of cataract extraction after vitrectomy than patients without diabetes, a study found. The finding suggests a lower rate of cataract formation in patients with diabetes, the study authors said.
Researchers William E. Smiddy, MD, and William Feuer, MS, said this is especially significant “because the risk ratio in patients with diabetes in general and in patients with a previous vitrectomy is likely less favorable compared with the general population.” Their study is published in the August issue of Retina.
Dr. Smith and Mr. Feuer measured the frequency of visually significant cataract after vitrectomy in 40 patients with diabetes and 56 concurrent control patients in a retrospective, consecutive, comparative case series. Phakic patients with a clear lens or mild lens opacity who underwent anatomically successful diabetic vitrectomy without lens removal were included if they had at least 1 year of postoperative follow-up. Vitrectomies were performed without intraocular gas or silicone oil use. Two comparative phakic control groups of patients undergoing vitrectomy for macular hole or epiretinal membrane were also followed for 1 year.
The principal outcome measure was cataract extraction after vitrectomy. A secondary endpoint was eyes that needed cataract extraction at final follow-up.
Of the total study participants with clear lenses preoperatively, there were 26 in the study group, 38 in the macular hole group and 18 in the epiretinal membrane group.
The cumulative cataract extraction rate at 2 years was 15% for the diabetic group, 66% for the macular hole group and 53% for the epiretinal membrane group. Patient age was a relevant factor on multivariate survival analysis, with younger age associated with a lower rate of progression to cataract, the authors said. In the four patients with diabetes who underwent cataract extraction, visual acuity improved at least two lines in one eye and did not change in three eyes.
Even when the researchers expanded the outcome measures to include study patients with mild lens opacities at baseline and those needing cataract surgery at the final follow-up visit, a strong statistically significant difference between the three groups still existed.