CATARACT SURGERY AND PROGRESSION OF DIABETIC RETINOPATHY

Abstract

Patient with diabetes mellitus have a higher prevalence of lens opacity 1 and cataract development at an earlier age than non diabetic. 2 Cataract in diabetes mellitus decreases the visual acuity, makes posterior segment evaluation and laser treatment difficult. Several studies have shown that there is progression of diabetic retinopathy after cataract surgery. In all studies, criteria for progression of diabetic retinopathy are: a) progression of any form/type or stage of diabetic eye (DE), nonproliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) to any advanced, recurrent form/ type or stage of NPDR or PDR and b) development of new clinically significant macular edema (CSME) and/or worsening/ recurrent of preexisting CSME defined by Early Treatment Diabetic Retinopathy Study (ETDRS). • More severe the preexisting diabetic retinopathy (DR), much worse the DR after cataract extraction. The progression of DR after cataract extraction is severe in Intracapsular Cataract Extraction (ICCE) than Extracapsular Cataract Extraction (ECCE) with Intraocular Lens (IOL) and Sutureless Small Incision Cataract Surgery (SICS) and Phacoemulcification. • Progression of DR increases with complicated cataract surgery, like posterior capsular rupture (PCR), vitreous loss and prolonged surgery. • The first 6 months period is crucial as a minimum period of follow up to detect progression of DR. • There are other several local and systemic risk factors for the progression of DR, like hypertension, renal failure, ischemic heart disease, high cholesterol and triglyceride level, pregnancy etc. Key Words: Diabetic retinopathy, cataract surgery, risk factors