DIABETIC n' CATARAC SURGERY

Effect of Diabetes on Visual Acuity following Phacoemulsification Cataract Surgery


Ming Yueh Lee,1,2 Rusnah BT Hussain,1 Muhaya BT Mohamad,2 AM Rizal3
1Ophthalmology Department, Hospital Pulau Pinang, Pulau Pinang, 2Ophthalmology Department, and 3Community Health Department, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Aim: To assess the effect of diabetes on visual acuity following phacoemulsification cataract surgery.
Methods: This was a comparative cross-sectional study of 51 eyes of patients with diabetes with no diabetic retinopathy and 51 eyes of patients without diabetes who underwent phacoemulsification cataract surgery.Visual acuity was assessed with the logMAR visual acuity chart for best-corrected near and distance vision at 1, 6, and 12 weeks postoperatively. Fundus photographs were taken at each follow-up visit for assessment and documentation of diabetic retinopathy. Glycosylated haemoglobin was determined for the patients with diabetes at the start (glycosylated haemoglobin1) and end (glycosylated haemoglobin2) of the study. The anterior chamber reaction was assessed on the first postoperative day for all patients. The follow-up period was 12 weeks.
Results: The eyes of patients with diabetes were significantly associated with poorer best-corrected near visual acuity (p = 0.027). These eyes also had a slower rate of best-corrected near and distance visual acuity improvement. The glycosylated haemoglobin1 and glycosylated haemoglobin2 were correlated with the best-corrected near visual acuity (r = 0.282 and p = 0.04; and r = 0.355, p = 0.01, respectively). A similar correlation was found for glycosylated haemoglobin1 and glycosylated haemoglobin2 for best-corrected distance visual acuity (r = 0.287, p = 0.04; and r = 0.393, p = 0.004, respectively). The anterior chamber reaction was generally more severe in the patients with diabetes. Five of 51 eyes of patients with diabetes (9.8%) developed mild non-proliferative diabetic retinopathy.
Conclusion: The patients with diabetes had significantly poorer best-corrected near visual acuity postoperatively, although there was no clinical evidence of diabetic retinopathy at the start of the study. The postoperative visual acuity was correlated with diabetic control.

Key words: Diabetic retinopathy, Phacoemulsification, Visual acuity

Asian J Ophthalmol. 2007;9:245-250.
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