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Diabetic patients have poorer phaco outcomes than nondiabetics
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GALVESTON, Texas — Diabetic patients have worse visual outcomes after small-incision phacoemulsification surgery than nondiabetics, according to a study here. Visual acuities of diabetic patients were improved by the cataract surgery, but not as much as in nondiabetic patients.
The study authors suggest that, given an inverse association between preop levels of retinopathy and visual outcome, it may be best to perform cataract surgery while the patient is in early stages of retinopathy.
Researchers at the University of Texas here retrospectively reviewed the charts of 106 patients with diabetes and 55 patients without who underwent small-incision phaco. Age, sex, preoperative best corrected visual acuity (BCVA) and visual potential were comparable in the two groups. At 1 year, BCVA was 20/40 in 82% of the diabetic group and in 95% of the control group (P = .01). Coexisting diabetes and preoperative levels of retinopathy were the most important factors affecting postop BCVA.
At 4 years, patients with diabetes were less likely than control patients to achieve a BCVA better than or equal to the preop visual potential (P = .011). Patients with nonproliferative diabetic retinopathy were nearly five times less likely to achieve a postop BCVA of 20/40 than patients with diabetes but no retinopathy. Patients with proliferative diabetic retinopathy were 30 times less likely (P < .0001) to achieve a BCVA of 20/40 than patients with diabetes but no retinopathy.
The study is published in the August issue of Journal of Cataract & Refractive Surgery.