Diabetic retinopathy's effect on early visual outcomes after cataract surgery

Patients with pre-existing diabetic retinopathy (DR) do not achieve visual outcomes following cataract surgery as good as those with diabetes mellitus but without DR, according to data presented by Jagadesh C. Reddy, MD, and Harini Indusekar, BScOptom, from Cataract and Refractive Services, Cornea Institute, LV Prasad Eye Institute, Hyderabad, India.

The data was presented in an e-poster at the American Society of Cataract and Refractive Surgery’s 2022 annual meeting in Washington, D.C.

The investigators reached this conclusion after analyzing the cataract surgery data collected from the electronic records of almost 42,000 patients who underwent surgery from January 2016 to February 2020. They focused on identifying the factors that impacted the visual acuity (VA) outcomes, specifically, VA of 20/40 or lower at 5 weeks after the surgery. Reddy and Indusekar then compared the VA of patients with/without diabetes including the patients with/without DR, they explained.

They found that among the patients with diabetes, DR was present in 20% of the eyes.

When broken down by groups, following cataract surgery, the corrected distance VA of 20/40 or higher was reached in 94%, 95%, and 80%, respectively, in the patients who did not have diabetes, those who had diabetes but no DR, and those who had diabetes and DR. This difference reached significance (P < 0.01), the authors reported.

The multivariate analysis also showed that increasing age (P < 0.01), presence of DR (P < 0.05), need for another surgery (P < 0.01), and body mass index (P < 0.01) were independent risk factor for poor VA outcomes.

The investigators concluded that patients who have pre-existing DR are less likely to achieve Snellen 20/40 or better vison after cataract surgery compared with the patients with diabetes but without DR. The results showed that the patients with diabetes and no DR had VA outcomes that were comparable to the patients without diabetes.