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S. Chatterjee, V. Savant, T. Marshall, P. Stavrou; Phacoemulsification and Diabetic Retinopathy: Is Ethnicity an Additional Risk Factor? . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3975.
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Purpose: Cataract surgery in diabetic patients is associated with worsening of diabetic retinopathy and maculopathy. Ethnic differences in the prevalence of diabetic macrovascular and microvascular disease, including retinopathy and nephropathy are known to exist. We postulate that cataract surgery in a diabetic ethnic population may be associated with a worse postoperative outcome. Methods: A retrospective case note analysis was performed on diabetic patients undergoing phacoemulsification. The inclusion criteria were (a) South Asian or Afro-Caribbean ethnicity, (b) monocular cases with a minimum postoperative follow-up of six months and (c) binocular cases with an interval of at least six months between the two operations. Development or progression of diabetic retinopathy or maculopathy and final visual outcome were recorded. A comparison of Snellen acuity pre- and 6 months post-operatively, using three categories of acuity (<= 6/60; 6/36 to 6/18; >= 6/12) was performed using the chi squared test. Results: Thirty diabetic patients were included in the study. The mean age was 68.9 +/- 10 years. There were 19 South Asians (Pakistani, Indian and Bangladeshi) and 11 Afro-Caribbeans. The mean postoperative follow up was 12.4 +/- 6.5 months. The median preoperative Snellen acuity was 6/36. Of the study eyes 86.7% had a final postoperative visual acuity of 6/12 or better and 63.3% improved by at least two lines of Snellen acuity. Postoperatively 76.7% cases showed no progression of retinopathy or maculopathy in the study eye and 23.4% showed either symmetric or asymmetric progression. Conclusions: The results suggest that ethnicity is not an additional risk factor for poor postoperative outcome or retinopathy progression in diabetic patients.
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