Uncomplicated phaco does not accelerate diabetic retinopathy

SHEFFIELD, England — Uncomplicated phacoemulsification does not cause progression of diabetic retinopathy, according to a small prospective study here. Any progression observed postop probably represents the natural history of the disease, the researchers said. Additionally, the development of clinically significant macular edema postop probably represents natural disease progression rather than being a direct effect of surgery, they added.

Researchers here with the Royal Hallamshire Hospital conducted a prospective trial in 50 patients with type 2 diabetes undergoing monocular phaco. The grade of diabetic retinopathy and diabetic maculopathy in the operated and unoperated eyes was assessed preoperatively and for 12 months postop.

Retinopathy progression was observed in 11 patients. In seven patients, the retinopathy progressed in both eyes, in three patients it progressed in the operated eye alone and in one patient it progressed in the fellow eye alone. Macular edema was observed in 13 eyes postop. Of those, four had transient pseudophakic cystoid macular edema and nine had true diabetic maculopathy. No significant difference was seen in the number of operated and fellow eyes whose retinopathy or maculopathy progressed postop.

The study is published in the May issue of British Journal of Ophthalmology.