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Category: Volume 07 Issue 06 June 2019
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Title: Visual Outcome after Phacoemulsification and Intraocular Lens Implantation in Diabetics

Authors: Dr Vijender Kour, Prof. (Dr) Syed Tariq Qureshi, Dr Arshi Nazir

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.79

Abstract

Background: The prevalence of diabetes mellitus is on a rise with its prevalence ranging from 2-30 % worldwide. The objectives of our study was conducted to investigate the effect of phacoemulsification cataract surgery with PC-IOL implantation on the visual outcome in the diabetic patients.

Methods: The study was conducted among diabetic individuals who were scheduled for phacoemulsification surgery with foldable IOL implantation at the said department. Diabetic individuals with any degree of cataract, Individuals who agreed for phacoemulsification surgery with foldable IOL implantation. A questionnaire was developed before the study to capture socio-demographic and clinical details. Diabetic individuals with any degree of cataract with indication for the surgery were recruited for the study. The patients were operated and were later followed up at 1 week, 1 month and 3 month interval.

Results: The mean age at surgery of group A subjects was 46 ± 8.7 years while for group B, the mean age at surgery was 49 ± 5.5 years. There was male preponderance in both the group with 10 males in group A while 7 males in group B. The mean duration of diabetes mellitus among both the groups varied with the mean duration of 8 ± 4.3 years in group A while 12 ± 3.4 years for group B. Group A subjects with no NPDR, mild or moderate NPDR had an increased best corrected visual acuity post-surgery at 1 week, 1 month and 3 month follow-up period. Similarly in group B subjects with severe NPDR, the best corrected visual acuity post-surgery at 1 week, 1 month and 3 month follow-up period was better than the pre-operative visual acuity readings.

Conclusion: The final visual outcome was improved in the majority of examined eyes.

Keywords: Phacoemulsification, NPDR, Diabetic eye, Cataract Surgery.

References

  1. Cunlife IA, Flanagan DV, George NDL, et al. Extracapsular cataract surgery with lens implantation in diabetics with and without proliferative retinopathy.Br J Ophthalmol 1991; 75: 9–12.
  2. Pollack A, Leiba H, Bukelman A. The course of diabetic retinopathy following cataract surgery in eyes previously treated by laser photocoagulation. Br J Ophthalmol 1992; 76: 228–331.
  3. Zheng L, Merriam JC, Zaider M. Astigmatism and visual recovery after “large incision” extracapsular cataract surgery and “small” incisions for phacoemulsification. Trans Am Ophthalmol Soc 1997;95:387–410; discussion 410–5
  4. Flanagan DW. Progression of diabetic retinopathy following cataract surgery: can it be prevented? (Editorial). Br J Ophthalmol 1996; 80: 778–779.
  5. Percival P. Use of heparin-modified lenses in high-risk cases for uveitis.Dev Ophthalmol1991;22:80–3.
  6. Zetterström C, Lundvall A, Olivestedt G. Exfoliation syndrome and heparin surface modified intraocular lenses. Acta Ophthalmol Scand1992;70:91–5
  7. Sheikh MS, Sheikh IS, Khan SMS, Mir S. Prevalence of type 2 diabetes mellitus among adult population of District Srinagar. Int J Diabetes Dev Ctries [Internet]. 2019; Available from: http://link.springer.com/10.1007/s13410-018-0704-4.
  8. Sheikh Mohd Saleem. Modified Kappuswamy scale updated for year 2018. Indian J Res. 2018;7(3):6–7.
  9. Antcliff RJ, Poulson A, Flanagan DW. Phacoemulsification in diabetics. Eye 1996;10:737–41.
  10. Toyama T, Ueta T, Yoshitani M, Sakata R, Numaga J. Visual acuity improvement after phacoemulsification cataract surgery in patients aged ≥90 years. BMC Ophthalmol. 2018;18(1):280. Published 2018 Oct 29. doi:10.1186/s12886-018-0950-8
  11. Henricsson M, Heijl A, Janzon L. Diabetic retinopathy before and after cataract surgery.Br J Ophthalmol1996;80:789–93.
  12. Wagner T, Knaflic D, Rauber M,et al. Influence of cataract surgery on the diabetic eye: a prospective study. Ger J Ophthalmol1996;5:79–83
  13. CunliVe IA, Flanagan DW, George ND,et al. Extracapsular cataract surgery with lens implantation in diabetics with and without proliferative retinopathy. Br J Ophthalmol 1991;75:9–12.
  14. Krupsky S, Zalish M, Oliver M,et al. Anterior segment complications in diabetic patients following extracapsular cataract extraction and posterior chamber intraocular lens implantation.Ophthalmic Surg1991;22:526–30.
  15. Zaczek A, Zetterström C. Aqueous flare intensity after phacoemulsification in patients with diabetes mellitus.J Cataract Refract Surg1998;24:1099–104.
  16. Benson WE, Brown GC, Tasman W,et al. Extracapsular cataract extraction with placement of a posterior chamber lens in patients with diabetic retinopathy. Ophthalmology 1993;100:730–8.
  17. Pollack A, Leiba H, Bukelman A,et al. The course of diabetic retinopathy following cataract surgery in eyes previously treated by laser photocoagulation.Br J Ophthalmol 1992,76:228–31.
  18. Brown N, Hungerford J. The influence of the size of the lens in ocular disease.Trans Ophthalmol Soc UK1982;102:359–63.
  19. Sparrow JM, Bron AJ, Phelps Brown NA,et al. Biometry of the crystalline lens in late onset diabetes: the importance of diabetic type.Br J Ophthalmol 1992;76:428–33.
  20. Sparrow JM, Bron AJ, Brown NA,et al. Auto fluorescence of the crystalline lens in early and late onset diabetes. Br J Ophthalmol1992;76:25–31
  21. Muller-Jensen K, Rorig M, Hagele J,et al.(EVect of cataract technique and duration of surgery on fibrin reaction after IOL implantation.) (French) Ophtalmologe 1997;94:38–40.
  22. Levin ML, Kincaid MC, Eifler CW,et al. EVect of cataract surgery and intraocular lenses on diabetic retinopathy. J Cataract Refract Surg1985;14:642–9.
  23. Dowler JG, Hykin PG, Lightman SL,et al. Visual acuity following extracapsular catract extraction in diabetes: a metaanalysis.Eye1995;9:313–7.
  24. Hykin PG, Gregson RM, Hamilton AM. Extracapsular cataract extraction in diabetics with rubeosis iridis. Eye 1992;6:296–9.

Corresponding Author

Dr Arshi Nazir

Senior Resident, Department of Ophthalmology, Government Medical College, Srinagar, India