The management of diabetic eye disease in the setting of cataract surgery

PURPOSE OF REVIEW: The increased incidence of diabetes mellitus worldwide is accompanied by an increased risk of co-morbid conditions, including the intersection of diabetes, diabetic retinopathy and cataracts. In an effort to improve the surgical outcomes for this population, it is necessary to understand the historical perspectives that have evolved into current treatment recommendations. RECENT FINDINGS: While cataract surgery in patients with no or mild retinopathy may result in minimal complications, a substantial minority of patients with diabetes and advanced retinopathy, including macular edema and a history of previous laser treatment, may require additional considerations when planning cataract surgery. Untreated retinopathy, insufficiently treated retinopathy or treatment failures can be challenging. In these instances, a paradigm shift may be indicated, and the occasion of cataract surgery may provide an opportunity to simultaneously treat retinopathy. By utilizing combined vitrectomy/cataract surgical techniques and/or pharmacologic interventions, improved results for a broader diabetic population may be attainable. SUMMARY: Newer surgical and pharmacologic therapies may now allow for safe and effective surgery in individuals who were previously not candidates for surgery or who had a limited visual prognosis.