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Cataract surgery in patients with diabetic retinopathy: visual outcome, progression of diabetic retinopathy, and incidence of diabetic macular oedema.

Abstract

BACKGROUND

Compared to non-diabetic patients, outcome after cataract surgery was reported to be worse in diabetic patients--especially in those with diabetic retinopathy. This prospective study was planned to evaluate visual outcome, progression of diabetic retinopathy, and incidence of clinically significant macular oedema (CSME) in a homogenous group of patients with non-proliferative diabetic retinopathy (NPDR) without CSME at baseline 1 year after cataract surgery.

METHODS

Over a period of 18 months, all consecutive patients with mild-to-moderate diabetic retinopathy who had cataract surgery with phacoemulsification and posterior chamber lens implantation were prospectively followed up. Outcomes were assessed 1 year postoperatively and included visual acuity (VA), progression of retinopathy, and incidence of CSME. Progression of retinopathy and incidence of CSME were compared to the non-operated fellow eyes.

RESULTS

Of 50 patients included, 42 completed the 1-year follow-up. VA improved in 85% of patients, and was better than 0,5 in 71%. Progression of retinopathy occurred in 12% of eyes after cataract surgery and in 10.8% of non-operated fellow eyes. No patient developed proliferative diabetic retinopathy in the operated eye. CSME occurred in 13 operated eyes (31%), five of them with retinal ischemia, and in five non-operated eyes (13.5%). Patients with ischemic macular oedema had the worst prognosis regarding VA.

CONCLUSION

Modern cataract surgery seems to have no influence on the progression of diabetic retinopathy. A visual improvement is achieved in the majority of patients with NPDR, but poorer visual outcome is observed in patients developing macular oedema.

Authors+Show Affiliations

Department of Ophthalmology, University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. katharina.krepler@akh-wien.ac.atNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12271370

Citation

Krepler, Katharina, et al. "Cataract Surgery in Patients With Diabetic Retinopathy: Visual Outcome, Progression of Diabetic Retinopathy, and Incidence of Diabetic Macular Oedema." Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, vol. 240, no. 9, 2002, pp. 735-8.
Krepler K, Biowski R, Schrey S, et al. Cataract surgery in patients with diabetic retinopathy: visual outcome, progression of diabetic retinopathy, and incidence of diabetic macular oedema. Graefes Arch Clin Exp Ophthalmol. 2002;240(9):735-8.
Krepler, K., Biowski, R., Schrey, S., Jandrasits, K., & Wedrich, A. (2002). Cataract surgery in patients with diabetic retinopathy: visual outcome, progression of diabetic retinopathy, and incidence of diabetic macular oedema. Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, 240(9), pp. 735-8.
Krepler K, et al. Cataract Surgery in Patients With Diabetic Retinopathy: Visual Outcome, Progression of Diabetic Retinopathy, and Incidence of Diabetic Macular Oedema. Graefes Arch Clin Exp Ophthalmol. 2002;240(9):735-8. PubMed PMID: 12271370.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cataract surgery in patients with diabetic retinopathy: visual outcome, progression of diabetic retinopathy, and incidence of diabetic macular oedema. AU - Krepler,Katharina, AU - Biowski,Robert, AU - Schrey,Susanne, AU - Jandrasits,Kerstin, AU - Wedrich,Andreas, Y1 - 2002/08/21/ PY - 2002/04/30/received PY - 2002/07/05/revised PY - 2002/07/05/accepted PY - 2002/9/25/pubmed PY - 2002/12/20/medline PY - 2002/9/25/entrez SP - 735 EP - 8 JF - Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie JO - Graefes Arch. Clin. Exp. Ophthalmol. VL - 240 IS - 9 N2 - BACKGROUND: Compared to non-diabetic patients, outcome after cataract surgery was reported to be worse in diabetic patients--especially in those with diabetic retinopathy. This prospective study was planned to evaluate visual outcome, progression of diabetic retinopathy, and incidence of clinically significant macular oedema (CSME) in a homogenous group of patients with non-proliferative diabetic retinopathy (NPDR) without CSME at baseline 1 year after cataract surgery. METHODS: Over a period of 18 months, all consecutive patients with mild-to-moderate diabetic retinopathy who had cataract surgery with phacoemulsification and posterior chamber lens implantation were prospectively followed up. Outcomes were assessed 1 year postoperatively and included visual acuity (VA), progression of retinopathy, and incidence of CSME. Progression of retinopathy and incidence of CSME were compared to the non-operated fellow eyes. RESULTS: Of 50 patients included, 42 completed the 1-year follow-up. VA improved in 85% of patients, and was better than 0,5 in 71%. Progression of retinopathy occurred in 12% of eyes after cataract surgery and in 10.8% of non-operated fellow eyes. No patient developed proliferative diabetic retinopathy in the operated eye. CSME occurred in 13 operated eyes (31%), five of them with retinal ischemia, and in five non-operated eyes (13.5%). Patients with ischemic macular oedema had the worst prognosis regarding VA. CONCLUSION: Modern cataract surgery seems to have no influence on the progression of diabetic retinopathy. A visual improvement is achieved in the majority of patients with NPDR, but poorer visual outcome is observed in patients developing macular oedema. SN - 0721-832X UR - https://www.unboundmedicine.com/medline/citation/12271370/Cataract_surgery_in_patients_with_diabetic_retinopathy:_visual_outcome_progression_of_diabetic_retinopathy_and_incidence_of_diabetic_macular_oedema_ L2 - https://dx.doi.org/10.1007/s00417-002-0530-7 DB - PRIME DP - Unbound Medicine ER -