May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Diabetic Retinopathy, Visual Acuity, and Quality of Life after Phacoemulsification in Patients with Diabetes Mellitus
Author Affiliations & Notes
  • G.K. Escaravage
    Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC
  • K.L. Cohen
    Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC
  • M.E. Hartnett
    Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC
  • S.B. Patel
    Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC
  • B.B. Armstrong
    Biostatistics, University of North Carolina at Chapel Hill, School of Public Health, Chapel Hill, NC
  • C.M. Janowski
    Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC
  • Footnotes
    Commercial Relationships  G.K. Escaravage, None; K.L. Cohen, None; M.E. Hartnett, None; S.B. Patel, None; B.B. Armstrong, None; C.M. Janowski, None.
  • Footnotes
    Support  Service Award: University of N. Carolina, School of Public Health, Program on Health Care Outcomes
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 303. doi:
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      G.K. Escaravage, K.L. Cohen, M.E. Hartnett, S.B. Patel, B.B. Armstrong, C.M. Janowski; Diabetic Retinopathy, Visual Acuity, and Quality of Life after Phacoemulsification in Patients with Diabetes Mellitus . Invest. Ophthalmol. Vis. Sci. 2004;45(13):303.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: Measure changes in diabetic retinopathy (DR), macular edema (ME), best corrected visual acuity (VA), and quality of life (QOL) after phacoemulsification (P). Methods: Using topical anesthesia, 30 eyes (24 subjects) had small incision P and acrylic IOLs (AMO, AR40e) injected. Postop treatment was a topical corticosteroid/antibiotic for 1 week, then a topical corticosteroid and topical NSAID for 5 weeks. VA (logMAR), DR and ME (ETDRS), and QOL (VF–14) were measured 42 days before P and 52 days after. DR was graded as none (0), mild–moderate nonproliferative (MNPDR), severe nonproliferative (SNPDR), very severe nonproliferative or early proliferative (PDR), high risk proliferative (HRPDR), post panretinal photocoagulation (PRP), or poor image (PI). ME was graded as none (0), mild (1), clinically significant ME (2), or PI. Wilcoxon signed rank tests compared surgical (S) and nonsurgical (NS) eyes as well as preop to postop changes in VA, DR, ME, and QOL. Spearman correlations determined relationships among these measurements. Results: For preop S and NS, #s in DR categories were (respectively): 0 (7, 10), MNPDR (10, 8), SNPDR (5, 5), PDR (1, 2), HRPDR (1, 0), PRP (4, 5), & PI (2, 0); #s in ME categories were: 0 (21, 19), 1 (3, 2), 2 (4, 9), & PI (2, 0). For postop S and NS, DR #s were (respectively): 0 (8, 9), MNPDR (6, 9), SNPDR (6, 5), PDR (4, 2), HRPDR (1, 1), PRP (3, 4), & PI (2, 0); ME #s were: 0 (20, 21), 1 (4, 3), 2 (5, 6), & PI (1, 0). For S, VA improved from a mean of 0.61 preop to 0.29 postop (p = 0.0002). The mean preop and postop values for DR and ME in S were not different [DR (2.46 to 2.54) and ME (0.46 to 0.48)]. For NS, the mean preop and postop values for VA (0.26 to 0.17), DR (2.47 to 2.43), and ME (0.70 to 0.53) were not different. For DR and ME, there were no differences between S and NS, preop or postop. Preop VA was worse in S than NS (p < 0.0001), though similar at postop. QOL improved after P (preop mean 75.4 to postop mean 84.9, p = 0.00114). For S, the improvements in VA and QOL were not correlated with changes in DR or ME. Conclusions: Cataract surgery is thought to decrease VA in diabetics due to postop ME. Our short–term study did not demonstrate an adverse effect of P. Using small incision P and aggressive treatment of inflammation, VA and QOL improved while DR and ME remained stable. Modern P techniques may allow for successful outcomes in patiets with diabetes without leading to worsening of DR and/or ME. Therefore, P should not be delayed because of DR and/or ME.

Keywords: diabetic retinopathy • cataract • visual acuity 
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