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Jin Cheol Lee, Yu-Cheol Kim, Kwang Soo Kim; The Effect of Diabetes on Cataract Progression in Patients who had done Pars plana vitrectomy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2627.
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The purpose of this study is to identify the effect of diabetes on the progression of cataract in patients who had phakic pars plana vitrectomy.
The study was done to 116 patients who had vitrectomy from January 2001 to December 2007. We divided the patients into two groups whether having diabetes or not, and in each group we searched their medical records in a retrograde fashion to study their age, diabetes management and systemic state, and the presence of intravitreal gas tamponade when performing vitrectomy which are the progression factors of cataract.
The patients who had vitrectomy were 116 in total. The diabetics were 68 (58.6%), whereas the non-diabetics were 48 (41.4%), and 54 (diabetics 26, non-diabetics 28) had vitrectomy and intravitreal gas tamponade at the same time. The mean age was 59.9 years (diabetics 58.4, non-diabetics 60.1), where the mean age was 59.8 ± 6.1 years in diabetics and 60.3 ± 6.7 years in non-diabetics who had surgery after vitrectomy, and 60.0 ± 8.9 years and 59.6 ± 5.4 years respectively in those who were only observed. The duration period from vitrectomy to the final lapsed date was longer in non-diabetics (p<0.05) being 64.7% (44 of 68) in diabetics and 87.0% (42 of 48) in non-diabetics.According to the time to the cataract surgery, in the group that the operation was done less than a year diabetics and non-diabetics each showed 6 (13.6%), 14 (33.2%) and for the group that took more 2 years it each was 24 (54.6%), 6 (14.8%) which implies there is a tendency of delay in the time of cataract operation in the diabetics (p<0.05). The date of observation was longer in diabetics (24, 35.3%) which was 67.3 months than that of the non-diabetics (6, 13.0%) which was 45.0 months.The mean HbA1C was 8.15 in the diabetics who took cataract surgery after vitrectomy which was 6.60 higher than that of the patient group with no cataract surgery but who was only on observation. And according to the time to the cataract surgery, for less than a year it was 8.73, for 1-2 years it was 7.62 and for more than 2 years it was 6.57 which showed a tendency of faster operation date in higher HbA1C groups.
We are able to conclude that the diabetics with vitrectomy will show slower progression of cataract than that of the non-diabetics. Thus it can be thought that it is better for the diabetic patients to have a primary vitrectomy to stabilize the macula before the cataract surgery because it will allow to reduce the refractive error after the cataract surgery, caused by inaccurate measurement of the axial length and also reduce other complications which are vision impairing factors. Because of these reasons it will be a more adequate way in the aspect of treatment and the prognosis.
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