Occurrence And Progression Of Diabetic Retinopathy After Phacoemulsification Cataract Surgery
To evaluate the risk factors associated with the occurrence and progression of diabetic retinopathy (DR) after phacoemulsification cataract surgery.Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel.The medical charts of 52 eyes of 48 consecutive patients who had phacoemulsification were retrospectively reviewed. The occurrence of DR (new development of any DR) and progression (DR requiring laser treatment) were correlated with patients' age, sex, duration of diabetes, control of diabetes, hypertension, ischemic heart disease, and surgical technique. Exclusion criteria were significant ocular conditions and a follow-up shorter than 6 months.The occurrence of DR was associated with male sex, and among males, with the duration of the disease. An analysis including all patients showed that postoperative progression of preexisting DR was not associated with any factor except poor blood sugar control. Neither the occurrence nor progression of DR was associated with reduced visual acuityThe occurrence and progression of DR after phacoemulsification were associated with different factors. Poor systemic control of diabetes increases the risk. Do you want to read the rest of this article? ... Cataract surgery in diabetic patients is associated with higher risk of postoperative complications. Posterior capsule opacifi cation (PCO), anterior capsule phimosis, severe infl ammation (fi brinous exudates and membrane), cystoid macular edema, and exacerbation of diabetic retinopathy are a few of the most important postoperative complications (Krupsky et al 1991; Chung et al 2002; Hayashi et al 2002; Hauser et al 2004; Ivancic et al 2005; Ebihara et al 2006). However the progression to a proliferative state is a common condition in these patients, fi nding new vessels Continue reading >>
Occurrence And Progression Of Diabetic Retinopathy After Phacoemulsification Cataract Surgery
Volume 30, Issue 2 , February 2004, Pages 428-432 Occurrence and progression of diabetic retinopathy after phacoemulsification cataract surgery Author links open overlay panel DavidHauserMD Get rights and content Purpose: To evaluate the risk factors associated with the occurrence and progression of diabetic retinopathy (DR) after phacoemulsification cataract surgery. Setting: Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel. Methods: The medical charts of 52 eyes of 48 consecutive patients who had phacoemulsification were retrospectively reviewed. The occurrence of DR (new development of any DR) and progression (DR requiring laser treatment) were correlated with patients' age, sex, duration of diabetes, control of diabetes, hypertension, ischemic heart disease, and surgical technique. Exclusion criteria were significant ocular conditions and a follow-up shorter than 6 months. Results: The occurrence of DR was associated with male sex, and among males, with the duration of the disease. An analysis including all patients showed that postoperative progression of preexisting DR was not associated with any factor except poor blood sugar control. Neither the occurrence nor progression of DR was associated with reduced visual acuity Conclusions: The occurrence and progression of DR after phacoemulsification were associated with different factors. Poor systemic control of diabetes increases the risk. Continue reading >>
The Impact Of Cataract Surgery On Preexisting Retinal Disease
The Impact of Cataract Surgery on Preexisting Retinal Disease Edited by Sharon Fekrat, MD, and Ingrid U. Scott, MD, MPH In the past two decades, there have been tremendous advances in cataract surgery. Better technology and greater proficiency allow safer and faster surgery, with better visual outcomes and shorter recovery times. And a more active and optically demanding aging population has led to the increased need for cataract surgery. One population-based study of the elderly in the United States found a dramatic linear increase in the rate of cataract surgery in the past 25 years. Despite this good news about cataract surgery, there is a growing awareness of the effect of cataract surgery on a range of preexisting retinal pathology, and the decision to perform cataract surgery in eyes with preexisting retinal disease is often challenging. Arguing for the removal of cataracts is the obvious fact that their presence can dramatically impair the patients vision and, for the physician, can hinder the visualization and management of underlying retinal pathology. Likewise, the ability to use optical coherence tomography for evaluating retinal thicknessa mainstay in todays management of many retinal diseasescan be markedly hindered by certain types of cataract. But cataract surgery can exacerbate retinal disease, and, ironically, some treatments for retinal disease, like intravitreal corticosteroids and pars plana vitrectomy, can themselves cause cataracts. This article will review recent evidence on the relationship between cataract surgery and some of the most common retinal diseases, namely, age-related macular degeneration, diabetic retinopathy, retinal vein occlusion (RVO), epiretinal membrane and vitreomacular traction, and it will discuss some perioperative measure Continue reading >>
Common Cataract Surgery Accelerates Diabetic Retina Deterioration
Common Cataract Surgery Accelerates Diabetic Retina Deterioration by Chris Emery, Contributing Writer, MedPage Today Explain to interested patients that phacoemulsification cataract surgery could result in development and progression of diabetic retinopathy. Note that phacoemulsification surgery results in less progression of retinopathy than the older methods of intracapsular and extracapsular cataract surgery. PRINCETON, N.J., July 31 -- Diabetics who undergo phacoemulsification cataract surgery risk doubling the rate at which their vision deteriorates because of damage to the capillaries that nourish the retina, a new study shows. However, phacoemulsification results in less progression of retinopathy than older methods of intracapsular and extracapsular cataract surgery, according to a report in the Aug. 1 edition of Ophthalmology. The older methods require larger incisions than phacoemulsification, Jie Jin Wang, MMed, PhD, of the University of Sydney, and colleagues noted. A year after phacoemulsification surgery, 28.2% of the eyes that were operated on developed diabetic retinopathy, compared to only 13.8% of the nonsurgical eyes (95% CI 1.06 to 6.61). In patients who had the surgery in only one eye, 35.6% of the eyes operated on showed signs of diabetic retinopathy progression compared to only 20% of the eyes that weren't surgically altered (95% CI 0.85 to 5.71). "We found that phacoemulsification surgery may still exacerbate the development and progression of diabetic retinopathy in older patients with diabetes, compared with fellow eyes of the same patients that had not undergone phacoemulsification surgery during a 12-month period." Even so, they concluded, "the risk magnitude for diabetic retinopathy progression after phacoemulsification surgery was found to Continue reading >>
Effect Of Cataract Surgery On The Progression Of Diabetic Retinopathy.
Effect of cataract surgery on the progression of diabetic retinopathy. Chung J, et al. J Cataract Refract Surg. 2002. Department of Ophthalmology, Uijongbu St. Mary's Hospital, The Catholic University Medical College, Seoul, South Korea. J Cataract Refract Surg. 2002 Apr;28(4):626-30. PURPOSE: To study the effect of cataract surgery and other factors on the progression of diabetic retinopathy using the nonoperated contralateral eye as a control. SETTING: Department of Ophthalmology, Catholic University Medical College, Uijongbu St. Mary's Hospital, Seoul, Korea. METHODS: Monocular cataract surgery was performed in 75 patients who had the same degree of retinopathy or no retinopathy in both eyes preoperatively. Patients were assigned to 1 of 2 groups as follows: Group A, progression of retinopathy in the operated eye caused by cataract surgery; Group B, no progression of retinopathy bilaterally, comparable level of progression in both eyes, or more progression of retinopathy in the nonoperated eye than in the operated eye. The differences between the 2 groups in age, duration of and treatment methods for diabetes, renal function, and presence of preoperative macular edema were compared. The 1-year follow-up included evaluation of the progression of retinopathy. RESULTS: Surgery caused the retinopathy to progress in 23 patients (30.6%, Group A); 52 patients (69.4%, Group B) had no progression of retinopathy or a comparable level of retinopathy postoperatively. The operated eye had more progression of retinopathy than the nonoperated contralateral eye (P <.05). There was no significant difference between the 2 groups in age, diabetes duration, surgical method, or hypertension. Preoperative macular edema and poor renal function significantly affected the progression of dia Continue reading >>
Cataract Surgery In Patients With Diabetic Retinopathy: Visual Outcome, Progression Of Diabetic Retinopathy, And Incidence Of Diabetic Macular Oedema
, Volume 240, Issue9 , pp 735738 | Cite as Cataract surgery in patients with diabetic retinopathy: Visual outcome, progression of diabetic retinopathy, and incidence of diabetic macular oedema Background. Compared to non-diabetic patients, outcome after cataract surgery was reported to be worse in diabetic patients especially in those with diabetic retinopathy. This prospective study was planned to evaluate visual outcome, progression of diabetic retinopathy, and incidence of clinically significant macular oedema (CSME) in a homogenous group of patients with non-proliferative diabetic retinopathy (NPDR) without CSME at baseline 1 year after cataract surgery. Methods. Over a period of 18 months, all consecutive patients with mild-to-moderate diabetic retinopathy who had cataract surgery with phacoemulsification and posterior chamber lens implantation were prospectively followed up. Outcomes were assessed 1 year postoperatively and included visual acuity (VA), progression of retinopathy, and incidence of CSME. Progression of retinopathy and incidence of CSME were compared to the non-operated fellow eyes. Results. Of 50 patients included, 42 completed the 1-year follow-up. VA improved in 85% of patients, and was better than 0,5 in 71%. Progression of retinopathy occurred in 12% of eyes after cataract surgery and in 10.8% of non-operated fellow eyes. No patient developed proliferative diabetic retinopathy in the operated eye. CSME occurred in 13 operated eyes (31%), five of them with retinal ischemia, and in five non-operated eyes (13.5%). Patients with ischemic macular oedema had the worst prognosis regarding VA. Conclusion. Modern cataract surgery seems to have no influence on the progression of diabetic retinopathy. A visual improvement is achieved in the majority of pa Continue reading >>
Severe Diabetic Retinopathy After Cataract Surgery
Volume 117, Issue 3 , March 1994, Pages 314-321 Severe Diabetic Retinopathy After Cataract Surgery Author links open overlay panel HowardSchatzM.D. DawnAtienzaB.A. H. RichardMcDonaldM.D. Robert N.JohnsonM.D. Get rights and content We retrospectively compared the visual acuity and degree of background diabetic retinopathy in 32 consecutive patients with diabetes who had cataract surgery in one eye (study group) and compared them with the visual acuity and degree of diabetic retinopathy in 32 patients with diabetes who had not had cataract surgery (control group) to determine if the retinopathy was asymmetric and worse in the operated-on eye. Twenty-three (72%) of the 32 study patients had asymmetric retinopathy (with the more severe retinopathy in the eye that underwent cataract surgery in each case) compared with three (9%) of the control group (P < .0005). The eyes that had cataract surgery did poorly in terms of visual acuity with no eyes achieving 20/20 or 20/25, only three eyes achieving 20/30 or 20/40, and 16 achieving 20/100 or worse. Continue reading >>
[progression Of Diabetic Retinopathy After Cataract Surgery By Phacoemulsification].
[Progression of diabetic retinopathy after cataract surgery by phacoemulsification]. Universit de Tunis El Manar, facult de mdecine de Tunis, 1007 Tunis, Tunisie. [email protected] J Fr Ophtalmol. 2013 Jan;36(1):62-5. doi: 10.1016/j.jfo.2012.06.009. Epub 2012 Aug 29. PURPOSE: To study the effect of cataract surgery by phacoemulsification and intraocular lens implantation on the progression of diabetic retinopathy (DR) using the nonoperated fellow eye as a control, by a retrospective comparative study. PATIENTS AND METHODS: We studied 46 diabetic patients who underwent monocular cataract surgery by phacoemulsification with implantation of an intraocular lens within the capsular bag, with the nonoperated fellow eye used as a control. In all cases, the fellow eye exhibited only a very mild cataract, allowing for visualization of the fundus. Preoperative and 1, 3, 6 and 12 months postoperative ophthalmic examination and fundus photographs, supplemented if necessary by retinal fluorescein angiography, were performed to assess DR using the Alfediam classification. Patients were followed for at least 1 year. RESULTS: Among the 46 patients, preoperative DR was absent in 40 patients, and six patients had bilateral, symmetric non-proliferate diabetic retinopathy (NPDR): mild in four patients, moderate in one patient and moderately severe in another patient. Thirty-five eyes (76%) had postoperative best corrected visual acuity of 8/10 or better. Progression of DR occurred at about 23.9% (11/46) in the operated eyes and 19.6% (9/46) in the nonoperated eyes. As compared by the MacNmar test, there was no significant difference between operated and nonoperated eyes (P=0.68). CONCLUSION: This study demonstrates that cataract surgery by phacoemulsification does not represent an appa Continue reading >>
Retina Today - Cataract Surgery In Diabetic Patients (july/august 2010)
Excellent outcomes can be achieved in these patients with appropriate attention to details. Diabetes is an increasingly common systemicdisease, and many patients seeking cataractsurgery have coexisting diabetic eye disease. Inan otherwise healthy eye, modern cataractsurgery can restore excellent vision and correct myopia,hyperopia, and astigmatism. But when there is coexistingdiabetic eye disease, cataract surgery may put additionalstress on the eye and can lead to macular edema, progressiveretinopathy, and limited vision. Although it is still possible to deliver excellent resultsfrom cataract surgery in diabetic patients, these patientsare at increased risk of complications and subsequentlimitation of vision. With careful preoperative planning,attention to detail during phacoemulsification, and closepostoperative supervision, diabetic patients can achieveexcellent vision after cataract surgery. Diabetic patients receive the same type of preoperativeevaluation as other cataract patients but with moreemphasis placed on the presence and extent of diabeticeye changes. Diabetic patients tend to develop cataractsearlier and may be more prone to developing posteriorsubcapsular cataracts than other patients, so they oftenpresent with cataracts at an earlier age. It is important toestablish that the degree of cataract seen corresponds tothe patients visual acuity and reported visual dysfunction.If the patient reports severe vision problems but theexam shows mild cataracts, one must look carefully atthe retina for other causes of visual loss. Diabetic retinopathy can be broadly divided into twocategories: background diabetic retinopathy and proliferativediabetic retinopathy. One of the key differentiating factorsis the presence of harmful neovascularization. Thegrowth of new ve Continue reading >>
Effect Of Cataract Surgery On Diabetic Retinopathy Ali Kg, Soliman Tt, Mohammed Aa - Benha Med J
The aim of this study was to review articles on the effect of cataract surgery on diabetic retinopathy (DR). Of the reviewed publications, it was found that diabetic patients with mild-to-moderate DR are less likely to show progression of DR after phacoemulsification. Patients with severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy have high risk of progression. Elevated hemoglobin A1c (HbA1c) at the time of cataract surgery increases the risk for DR progression after surgery. Currently, early surgery is favored before the development of significant DR rather than waiting for the cataract to become denser. All efforts should be made to stabilize DR before cataract surgery. Keywords:Cataract surgery, diabetic retinopathy, macular edema, phacoemulsification Ali KG, Soliman TT, Mohammed AA. Effect of cataract surgery on diabetic retinopathy. Benha Med J 2015;32:92-5 Ali KG, Soliman TT, Mohammed AA. Effect of cataract surgery on diabetic retinopathy. Benha Med J [serial online] 2015 [cited2018 Apr 25];32:92-5. Available from: Diabetes mellitus (DM) is a growing major health concern worldwide. In industrialized countries, 1% of the population is diabetic, and at least another 1% comprises undiagnosed diabetic patients [1] . Diabetic retinopathy (DR), a well-known consequence of long-standing and poorly controlled DM, causes significant vision loss and blindness in the human population [2] . Diabetic macular edema (DME) is the major vision-threatening complication of DR. The Wisconsin Epidemiologic Study has reported that the prevalence of DME in diabetic patients of 15-year duration is 20% in patients with type I DM and 25% in patients with type II DM who are on treatment [3] . Studies have demonstrated that patients with DM are two to five Continue reading >>
The Association Between Cataract Surgery And Progression Of Diabetic Retinopathy Stein, Joshua D. University Of Michigan Ann Arbor, Ann Arbor, Mi, United States
The Association Between Cataract Surgery and Progression of Diabetic Retinopathy In the United States, diabetes mellitus (DM), a major cause of blindness, affects more than 21 million persons. The most common reasons for vision loss in those with DM are cataract and diabetic retinopathy (DR). Success rates of cataract surgery in persons without DM are generally very high. However, in multiple relatively small observational studies, a subset of patients with DM experience progression of DR after cataract surgery and less-favorable outcomes. Given the high costs of resources to monitor and treat cataract and DR (>$5 billion in 1996-2000) and that diagnoses of these conditions will increase as the U.S. population ages, it is important from both patient-care and health-policy perspectives to identify possible risk factors for DR progression after cataract surgery. Analyses using large health care databases can reveal patterns of care and health outcomes for various medical conditions. The proposed study would analyze longitudinal data from such sources to better understand the possible association of cataract surgery with development or progression of DR. Unlike the previous small observational studies on this topic, this project would include thousands of patients with DM undergoing cataract surgery. Furthermore, this type of study costs considerably less than conducting a randomized, controlled trial. This study uses two data sources: (1) the Medicare Current Beneficiaries Survey (1992-2005), a survey with longitudinal data on medical services utilization and costs for a nationally representative sample of more than 12,000 Medicare beneficiaries annually, and (2) the i3 InVision(tm) Data Mart (2004-2007), a large managed-care database with detailed information on more th Continue reading >>
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Cataracts In Diabetes
What you can do Controlling diabetes The operation Bupa factsheet macula oedema higher risk of infections Cataracts Normally light enters the eye from the front, passes through a clear lens, and reaches the back of the eye so you can see. If the lens becomes cloudy like frosted glass, light cannot pass through, and you cannot see properly. 'Cataract' is the name of the 'cloudy' human lens. Think of a camera, with a lens that bends the light so that the light 'focuses' onto the film at the back. If this lens becomes scratched or greasy, it cannot bend the light in the correct direction, and the light is scattered in all directions. You may notice blurred or mis ty sight, see double, or notice colours appear much duller than they did previously. bottom: a cloudy lens = a cataract. Light entering the eye is scattered What you can do A cataract will not damage your eye in any way. It can be operated on safely at any time, thick or thin. A cataract may change the focusing in the eye, and you may need new spectacles now and again. If you think you do, ask your optician or the doctor in the hospital eye clinic. But glasses themselves do not help you see better if you have a cataract. Some cataracts get worse quickly, others slowly: most do get worse over months or years. If your sight gets worse very slowly, the cataract is only slowly becoming thick. The thicker or cloudier the cataract becomes, the worse the sight. A doctor cannot predict with certainty. Reading Large print is naturally much easier to read, and a magnifying glass may help (see Coping with poor vision). A good light may help, particularly an anglepoise light behind the shoulder. Stronger glasses that mean you can bring books closer to your eye to make reading easier, and an optician (optometrist) can advise y Continue reading >>
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Midterm Visual Outcome And Progression Of Diabetic Retinopathy Following Cataract Surgery
Original Paper Travail original Originalarbeit Midterm Visual Outcome and Progression of Diabetic Retinopathy following Cataract Surgery Midterm Outcome of Cataract Surgery in Diabetes Schrey S. Krepler K. Biowski R. Wedrich A. I have read the Karger Terms and Conditions and agree. I have read the Karger Terms and Conditions and agree. Buy a Karger Article Bundle (KAB) and profit from a discount! If you would like to redeem your KAB credit, please log in . Save over 20% compared to the individual article price. Buy Cloud Access for unlimited viewing via different devices Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use * The final prices may differ from the prices shown due to specifics of VAT rules. For additional information: Objective: To assess the influence of cataract surgery on progression of diabetic retinopathy and visual acuity. Methods: 37 patient eyes with mild to moderate diabetic retinopathy at baseline underwent phacoemulsification and intraocular posterior chamber lens implantation. They were examined 3.3 (SD) 0.7 years after surgery. Results: 83.8% of the eyes showed a better final visual acuity, and 67.6% achieved a final visual acuity of 0.5 or better. The retinopathy remained unchanged in 83.8% and progressed in 16.2% of the eyes. No eye progressed to proliferative retinopathy. Conclusion: Phacoemulsification and implantation of a posterior chamber intraocular lens is a safe procedure for patients with mild to moderate diabetic retinopathy. Gilvarry A, Eustace P: The medical profile of cataract patients. Trans Ophthalmol Soc UK 1982;102:502504. National Society to Prevent Blindness: Vision Problems in the USA: A Continue reading >>
Diabetic Retinopathy Before And After Cataract Surgery.
Diabetic retinopathy before and after cataract surgery. This article has been cited by other articles in PMC. AIMS/BACKGROUND: Increased retinopathy progression has been reported after cataract surgery in patients with diabetes mellitus. To assess the influence of cataract surgery on visual acuity and retinopathy progression, all diabetic patients who were subjected to cataract surgery during 1991-3 have been followed up at the Department of Ophthalmology in Helsingborg. The average follow up time was 2 years. METHODS: One eye of each of 70 patients was included in the study, 35 monocularly and 35 binocularly operated on. Sixteen of the 70 patients had proliferative diabetic retinopathy (PDR) at baseline. The Wisconsin scale was used for the grading of retinopathy. The degree of glycaemic control was assessed by measurements of HbA1c. RESULTS: Most patients obtained improved visual acuity; a postoperative visual acuity of 0.5 or better was achieved in 89% of diabetic surgical eyes. Progression of the retinopathy occurred in 30 out of the 70 eyes, and was associated with mean level of HbA1c (p = 0.04), duration of diabetes (p = 0.02), insulin treatment (p = 0.001), and presence of retinopathy at baseline (p = 0.01). Patients who progressed had a significantly higher incidence of macular oedema (p = 0.006) than those who did not progress. No significant differences were found when operated and non-operated eyes were compared in the 35 patients with monocular surgery. Two patients in this group, however, ended up with macular oedema and worse vision in the operated eye than in the eye which was not operated on. Both patients had background retinopathy before surgery. CONCLUSIONS: Patients in this study, also those with PDR, obtained good visual acuity, better than in most Continue reading >>
Community Eye Health Journal Cataract And Diabetic Retinopathy
Comm Eye Health Vol. 24 No. 75 2011 pp 09. Published online 31 October 2011. Vitreoretinal consultant, University of Cape Town, Division of Ophthalmology, Faculty of Health Sciences, H53 Old Main Building, Groote Schuur Hospital, Observatory 7925, South Africa. Email: [email protected] When managing the cataract of a patient with diabetes, you should remember that cataract surgery may make diabetic retinopathy worse. Eyes with mild to moderate non-proliferative diabetic retinopathy at the time of surgery are considered less at risk. Those with severe non-proliferative and proliferative diabetic retinopathy have a higher risk of progressive disease. 1 Clinically significant macular oedema (CSMO) present at the time of surgery is likely to progress and eyes with previously treated CSMO are at increased risk of recurrence. The risk of progression is increased if the operation is complicated by excessive manipulation, vitreous loss, or severe post-operative inflammation. Ideally, when the cataract does not preclude laser treatment, you should achieve and maintain effective control of retinopathy and maculopathy for at least three months before surgery. The severity of the cataract sometimes prevents adequate examination or treatment of the retina in patients with diagnosed or suspected severe non-proliferative and proliferative diabetic retinopathy. In this case, you should deliver pan-retinal photocoagulation either during the procedure or in the early post-operative period. When performing intraoperative pan-retinal photocoagulation with an indirect ophthalmoscope, you should fill the anterior chamber with viscoelastic and place a corneal suture. Complete the pan-retinal photocoagulation before inserting the intraocular lens. This will provide a stable anterior chambe Continue reading >>
