Nonproliferative diabetic retinopathy and macular edema progression after phacoemulsification: prospective study

PURPOSE: To determine the incidence of diabetic retinopathy (DR) progression after phacoemulsification in patients with type II diabetes. SETTING: Service of Ophthalmology, University of Sant Joan, Barcelona, Spain. METHODS: This prospective study evaluated 132 patients with diabetes mellitus who had monocular phacoemulsification. A control group comprised the patients' contralateral eyes. Data analysis included preoperative retinal findings and DR status; hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol, and triglycerides levels; insulin treatment; and arterial hypertension. RESULTS: Postoperative visual acuity increased by 2 or more lines in 105 patients (79.55%); the mean postoperative acuity was 0.63 +/- 0.28 (SD). Diabetic retinopathy in the operated eye progressed in 31 patients (23.48%) and in the fellow eye in 28 patients (21.21%). The progression was associated with high levels of HbA1c and diabetes mellitus duration in both groups. Diabetic macular edema occurred in the operated eye in 8 patients (6.06%) and in the fellow eye in 6 patients (4.54%). Pseudophakic macular edema developed in 2 eyes (1.52%). The progression of diabetic macular edema was not associated with the risk factors studied. CONCLUSION: Uneventful phacoemulsification cataract surgery may not cause DR progression.