Long-term prognosis of extracapsular cataract extraction and intraocular lens implantation in diabetic patients.
Although cataract extraction with intraocular lens implantation (IOL) is being used for increasing numbers of patients, there is still insufficient information regarding the long-term outcome for these patients. In this retrospective study of 140 eyes of 102 patients, 97 eyes (69%) achieved a best visual acuity of 20/40 or better. After a minimum 6-month postoperative period, 26 eyes (19%) had developed retinopathy: eight eyes progressed from nonproliferative to proliferative retinopathy. Glycosylated hemoglobin levels and fasting blood glucose were significantly higher at time of surgery in the eight that progressed than in those who did not (P = 0.002, P = 0.034). There were 65 unilateral IOL implantations; in 10 (15%) of these eyes, retinopathy progressed. Retinopathy also progressed in 70% of the fellow eyes of these patients. In patients whose retinopathy did not progress, 95% of the fellow eyes also showed no progression. Also, patients with progression in the pseudophakic eye frequently had progression in the fellow unoperated eye. Postoperative progression was symmetrical (P = 0.0001). Our analysis suggests that progression of diabetic retinopathy following IOL implantation can be correlated to diabetic control at the time of surgery.
Tsujikawa
A
A
Department of Ophthalmology, Kyoto University, Faculty of Medicine, Japan.
Otani
A
A
Takanashi
T
T
Ogura
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D002387:Cataract Extraction; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D019904:Polymethyl Methacrylate