Evaluation of Visual Outcomes of Cataract Surgery in Diabetic Patients and Assessment of Post-operative Complications as Compared to Non-diabetics NC10-NC14
Dr. Shobha G Pai,
Professor and Head, Department of Ophthalmology, Kasturba Medical College, Mangalore, Karnataka, India.
Introduction: A leading cause of vision loss in the young adult population worldwide is sequelae and complications of diabetes. Cataract surgery performed on diabetic patients accounts for approximately 20% of total cataract surgeries. Cataract in patients with diabetes leads to decreased visual acuity and poses difficulty in examination of the retina adequately. Hence, it is advantageous to perform cataract surgery for diagnostic and therapeutic benefits, even if there is possible associated risk of aggravating the retinopathy.
Aim: Evaluation and comparison of visual outcomes after cataract surgery in diabetic and non-diabetic patients; and assessment of post-operative complications.
Materials and Methods: A prospective study was done to evaluate visual outcomes and post-operative complications after cataract surgery in 150 diabetics as compared to 150 non-diabetics; among the diabetics, 114 eyes were with mild Non Proliferative Diabetic Retinopathy (NPDR), 32 with moderate and 4 with severe NPDR. Central Foveal Thickness (CFT) measurement using Optical Coherence Tomography (OCT) was done for a homogenous group of 20 diabetics without proliferative retinopathy or Clinically Significant Macular Oedema (CSME) at baseline, and compared to 20 non-diabetics, to look for macular oedema, before and 6 weeks after cataract surgery. Qualitative data analysis was performed using student’s unpaired t-test. Quantitative data analysis was performed using Chi-square test. SPSS version 17.0 was used for analysis.
Results: The parameters to be evaluated were CFT, visual outcome and macular oedema before and 6 weeks after surgery. Diabetics showed a marginally higher incidence of increased CFT on OCT after cataract surgery. Poor glycaemic control and pre-existing diabetic retinopathy were compared with a significant decrease of the visual outcomes and these patients had an increased incidence of post-operative complications.
Conclusion: Adequate glycaemic control and the management of diabetic retinopathy would help to improve post-operative vision following cataract surgery.