Effect of Phacoemulsification on the Progression of Diabetic Retinopathy and Diabetic Macular Edema

Abstract

Background: DR is the leading cause of vision loss in adults aged 22-74 years. DR ranked as the fth most common causes of preventable blindness. In cataract surgery, blood aqueous barrier is impaired leading to an increased risk of post-operative inammation and development of a sight-threatening macular edema in diabetics with or without evidence of diabetic retinopathy. The study described herein is to investigate the effect of phacoemulsication surgery on the progression of diabetic retinopathy and diabetic macular edema after phacoemulsication cataract surgery. Material And Methods: Arandomized control trial was conducted in the Department of Ophthalmology, RIMS, Imphal, Manipur for a period of 24 months with effect from September 2017 to August 2019 among 50 patients aged between 18 to 80 years with type 2 diabetes mellitus admitted for phacoemulsication surgery to determine the effect of phacoemulsication on the progression of diabetic retinopathy and diabetic macular edema. Patient's diabetic retinopathy and Diabetic macular edema were graded using Early Treatment Diabetic Retinopathy Study criteria pre and post operatively. The results were tabulated and statistically evaluated using proper methods. Results: There was signicant improvement in the visual acuity after cataract surgery for all levels of preoperative retinopathy. Progression of retinopathy was seen in 10% case eye and 8% in fellow control group which was comparable in both the groups. The nding was statistically insignicant (p>0.05). In only 2% of the patient diabetic macular edema developed at 6 month follow-up. Conclusion: Phacoemulsication cataract surgery does not cause acceleration of diabetic retinopathy and diabetic macular edema post operatively and any progression that is observed probably represents the natural course of the disease rather than being a direct effect of surgery.