Comparative study of post-operative visual outcome and complications after small incision cataract surgery in patients of diabetic and non-diabetic patients of cataract
Abstract
Objective: The purpose of the study was to compare post-operative visual outcome and complications after small incision cataract surgery (SICS) in diabetic and non-diabetic patients of cataract.
Method:This was prospective comparative study of 60patients having diabetes and 60 patients having cataract with no diabetes mellitus undergoing SICS. All patients underwent complete ocular examination including best corrected visual acuity, slit lamp bio microscopy,and 90D examination preoperative and postoperatively at 1week,4 week, 6week,2 months, 6 months interval. Intraoperative and postoperative complications and best corrected visual acuity were noted.
Result: Mean of best corrected visual acuity postoperatively was 6/36 in diabetic patients while it was 6/6 in non-diabetic patients. Patients with no retinopathy in diabetic group improved to 6/12-6/9, in non-proliferative diabetic retinopathy (NPDR) without maculopathy to 6/12-6/18, NPDR with maculopathy improved to 6/36, cases with proliferative diabetic retinopathy (PDR) with maculopathy had vision finger counting close to face and patients with PDR without maculopathy had vision 5/60-6/60.This value is statistically significant p=0.022.suggesting worsening of visual outcome after small incision cataract surgery in diabetic patients due to diabetic retinopathy. Also,postoperative complications were noticed more in diabetic patients than anothernon-diabetic group who underwent SICS.
Conclusion: SICS is a safe procedure in diabetic patients and decreased vision is attributed to preoperative diabetic retinopathy and worsening of diabetic retinopathy after small incision cataract surgery and not with the procedure per se. Visual acuity are almost same in diabetes and non- diabetes except for late stage. Complications are found more in diabetic patients.
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References
2. Cunliffe IA Flanagan DW, George NDL, Aggrawal RJ, Moore AT. Extracapsular cataract extraction with lens implantation in diabetics with or without proliferative retinopathy. Br J Ophthalmo 1991;75(1):9 -12.
3. Klein BE, Klein R, Moss SE. Incidence of cataract surgery in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Am J Ophthalmol. 1995 Mar;119(3):295-300.[pubmed]
4. Krupsky S, Zalish M, Oliver M, Pollack A. Anterior segment complications in diabetic patients following extracapsular cataract extractionand posterior chamber intraocular lens implantation. Ophthalmic Surg. 1991 Sep; 22(9):526-30.[pubmed]
5. Zaczek A, Olivestedt G, Zetterström C. Visual outcome after phacoemulsification and IOL implantation in diabetic patients. Br J Ophthalmol. 1999 Sep;83(9):1036-41.[pubmed]
6. Tabin G, Chen M, Espandar L. Cataract surgery for the developing world. OpinOphthalmol. 2008 Jan;19(1):55-9. doi:10.1097/ICU.0b013e3282f154bd.[pubmed]
7. Gadkari SS, Maskati QB, Nayak BK. Prevalence of diabetic retinopathy in India: The All India Ophthalmological Society Diabetic Retinopathy Eye Screening Study 2014. Indian J Ophthalmol. 2016 Jan;64(1):38-44. doi:10.4103/0301-4738.178144.
8. Raman R, Rani PK, ReddiRachepalle S, et al. Prevalence of diabetic retinopathy in India: SankaraNethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study report 2. DOI:10.1016/j.ophtha.2008.09.010Ophthalmology. 2009 Feb;116(2):311-8.[pubmed]
9. Klein R, Klein BE, Moss SE, et al. The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol. 1984 Apr;102(4):520-6.[pubmed]
10. Niazi KM, Akram A, Naz AM, Awan S. Duration of diabetes as a significant factor for retinopathy. Pak J Ophthalmol. 2010;26(4):182–87.
11. Takamura Y, Tomomatsu T, Arimura S, et al. Anterior capsule contraction and flare intensity in the early stages after cataract surgery in eyes with diabetic retinopathy. J Cataract Refract Surg 2013;39(5):716–21.[pubmed]
12. Hreidarsson AB. Pupil motility in long-term diabetes. Diabetologia. 1979 Sep;17(3):145-50.[pubmed]
13. Hayashi K, Hayashi H, Nakao F, Hayashi F. Posterior capsule opacification after cataract surgery in patients with diabetes mellitus. Am J Ophthalmol. 2002 Jul;134(1):10-6.[pubmed]
14. Knorz MC, Soltau JB, Seiberth V, Lorger C. Incidence of posterior capsule opacification after extracapsular cataract extraction in diabetic patients. MetabPediatrSystOphthalmol1991;75:9–12.
15. Aiello LM, Wand M, Liang G. Neovascular glaucoma and vitreous hemorrhage following cataract surgery in patients with diabetes mellitus. Ophthalmology. 1983 Jul;90(7):814-20.[pubmed]
16. Townes CD, Casey ER. Cataract surgery in diabetic patients. South Med J. 1955 Aug;48(8):844-6.[pubmed]
17. Cramer FK. Operative complications of cataract extraction in diabetics. Int Ophthalmol Clin. 1963 Sep;3:645-56.[pubmed]
18. Chitkara DK, Smerdon DL. Risk factors, complications, and results in extracapsular cataract extraction. J Cataract Refract Surg. 1997 May;23(4):570-4.[pubmed]
19. Ninn-Pedersen K, Stenevi U. Cataract surgery in a Swedish population: observations and complications. J Cataract Refract Surg. 1996 Dec;22(10):1498-505.[pubmed]
20. Lumme P, Laatikainen LT. Risk factors for intraoperative and early postoperative complications in extracapsular cataract surgery. Eur J Ophthalmol. 1994 Jul-Sep;4(3):151-8.
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