Phacoemulsification cataract surgery in a large cohort of diabetes patients: visual acuity outcomes and prognostic factors.

PURPOSE: To assess visual acuity outcomes after phacoemulsification cataract surgery in a large population of diabetic patients with all degrees of diabetic retinopathy.

SETTING

Diabetology and ophthalmology unit, Copenhagen, Denmark.

DESIGN

Cohort study.

METHODS

This review of prospectively collected data comprised patients who had small-incision phacoemulsification cataract surgery between 1999 and 2008 (10 years) according to the Danish National Patient Registry.

RESULTS

Data of 7323 diabetic patients were reviewed. Of these patients, 285 had cataract surgery. The corrected distance visual acuity (CDVA) increased significantly after cataract surgery (P<.001; P<.05 in all diabetic retinopathy categories). The postoperative CDVA outcome was positively correlated with preoperative CDVA and negatively correlated with the degree of diabetic retinopathy and age (P<.001). Patients with a history of focal laser treatment for clinically significant macular edema had a higher risk for not gaining from cataract surgery (P=.04; relative risk, 1.6). In post hoc analysis, the proportion of patients in the cohort without diabetic retinopathy appeared to increase the year before cataract surgery (P=.03) and decrease the year after cataract surgery (P<.001).

CONCLUSIONS

The CDVA increased significantly after phacoemulsification cataract surgery in diabetic patients regardless of the degree of diabetic retinopathy. The apparent progression in diabetic retinopathy after modern cataract surgery seems to reflect the masking of low grades of diabetic retinopathy by preoperative lens opacities.

FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.