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Ankara Numune Eğitim ve Araştırma Hastanesi 1. Göz Kliniği, Ankara Purpose: To investigate the effects of type of cataract surgery, preoperative retinopathy level, and duration of diabetes on retinopathy progression, and visual outcomes after phacoemulsification or extracapsular cataract extraction in patients with diabetes mellitus in a prospective and case controlled study.
Materials and Methods: A clinical and angiographic review of 54 diabetic patients who underwent two distinct types of cataract surgery was prospectively performed in two groups during a 9-month period. There were 20 diabetic patients who underwent phacoemulsification surgery in group 1, 34 diabetic patients who underwent extracapsular cataract surgery in group 2. Cataract surgery was performed in one single eye of each patient while fellow eyes were used as controls.
Results: Progression rate of diabetic retinopathy was 25 % in eyes which underwent phacoemulsification, 23.5% in eyes with extracapsular cataract extraction and the difference was not significant (p>0.05). The difference between operated and fellow eyes in terms of progression of retinopathy was not significant in patients with phacoemulsification (p>0.05), while progression rate was significantly higher in the operated eyes in extracapsular extraction group (p<0.05). Duration of diabetes was longer in eyes with progression independent of the surgical technique (p<0.05). Significant visual improvement was achieved in both operated groups, however improvement was to a lesser extent in group 2 (61.8 %, p<0.05).
Conclusion: In diabetic patients who underwent cataract surgery progression of retinopathy is faster than the natural course of the disease in unoperated eyes. Progression of retinopathy is more frequent in the operated eyes of patients who underwent extracapsular cataract extraction. Higher duration of diabetes, preoperative retinopathy and postoperative progression are factors that negatively influence the visual outcome. Phacoemulsification technique might be more favourable in terms of visual improvement in diabetic patients. Keywords : Phacoemulsification, Extracapsular cataract extraction, Diabetic retinopathy