To study the outcomes of uneventful cataract surgery in diabetic patients without retinal complications.

Purpose: To examine preoperative anti-inflammatory treatment on recovery from cataract surgery in eyes of diabetic patients. Methods: A Prospective randomized clinical trial. One hundred and three eyes of 103 patients with diabetes undergoing routine cataract surgery were randomized (1:1) not to receive any preoperative anti-inflammatory medication or to receive preoperative topical anti-inflammatory medication with a combination of prednisolone acetate (10 mg/ml) and nepafenac (1 mg/ml). All eyes received postoperative anti-inflammatory combination therapy for 3 weeks. Recovery from surgery was recorded by a structured home questionnaire. Clinical outcome parameters were recorded at 28 days and 3 months. Results: Patient age and gender distribution, and all baseline ophthalmic and systemic parameters were comparable between the study groups. After surgery, conjunctival injection lasted 2.4 AE 1.7 days (mean AE SD) and irritation of the eye 3.3 AE 3.9 days in eyes without preoperative treatment, when compared to 1.6 AE 1.6 days (p = 0.067) and 2.4 AE 4.0 days (p = 0.431), respectively, in eyes with preoperative treatment. At 28 days, central subfield macular thickness (CSMT) increased 2.2 AE 20.2 lm in eyes without preoperative treatment, when compared 0.1 AE 25.2 lm (p = 0.670) in eyes with preoperative treatment. At 3 months, the respective CSMT change from baseline was À1.5 AE 26.9 lm and À3.4 AE 26.2 lm (p = 0.762). None of the eyes were reported with pseudophakic cystoid macular oedema (PCME) in either group. Conclusion: Lack of preoperative anti-inflammatory treatment does not impair recovery from surgery or predispose diabetic patients to increased risk of PCME in eyes postoperatively treated with combination therapy of prednisolone acetate and nepafenac.

Systemic vasoactive medication may be protective against CRT change induced by cataract surgery in eyes at risk of PCME such as those with postoperative steroid monotherapy.