Abstract
Purpose: :
To determine whether there is an increased incidence of intra-operative complications, specifically posterior capsular rupture, and development of cystoid macular edema (CME) following cataract surgery by resident surgeons in diabetic versus non-diabetic patients.
Methods: :
: Retrospective chart review of 577 consecutive cataract surgeries performed on 474 patients at Cooper University Hospital between January 3, 2003 and December 22, 2006. All cases were performed by resident surgeons supervised by one attending physician. Patients were divided into two groups, diabetic or non-diabetic. These two groups were then subdivided into two groups, those with intra-operative complications and those without. Patients were followed for visual acuity and development of cystoid macular edema up to one year post-operatively.
Results: :
Of the 577 cataract surgeries performed, there were a total of 262 cases involving diabetic patients and 315 cases that were non-diabetic. In the diabetic group 43 of 262 (16.4%) cases involved intra-operative complications. Of these cases 23 had posterior capsular rupture. In the non-diabetic group 28 of 315 (8.9%) cases involved intra-ocular complications including 11 with posterior capsular rupture. In the groups with complications there were 11 of 43 cases (25.6%) of diabetics and 4 of 28 cases (14.3%) of non-diabetics that ultimately developed CME. Mean number of days till diagnosis of CME in the diabetic and non-diabetic population was 45.7 and 56.7 respectively.
Conclusions: :
In cataract surgery performed by resident surgeons a pre-operative diagnosis of diabetes is associated with an increased incidence of intraocular complications and the development of post-operative CME compared to non-diabetics. It may be appropriate to consider selection of non-diabetic patients for resident surgeons early in training.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • diabetes • cataract