Diabetes and diabetic retinopathy in patients undergoing cataract surgery: a prevalence study—DiCat study report #2

Rossi, Tommaso; Panozzo, Giacomo; Mura, Giulia Della; Giannarelli, Diana; Ferrari, Daniele; Alessio, Giovanni; Palmisano, Carmela; Telani, Serena; Ripandelli, Guido

doi:10.1007/s00592-019-01466-8

Cited by 10 publications

(6 citation statements)

References 33 publications

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“…The corneal epithelium and endothelium of diabetic patients are easily damaged and have a slow recovery rate. Additionally, due to abnormal metabolism of microvascular and peripheral nerves, diabetic cataract surgery is more prone to complications such as miosis, iris hemorrhage, and corneal incision edema[ 10 , 11 ]. Diabetic cataract patients are also more sensitive to surgical stimulation.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of femtosecond laser-assisted phacoemulsification in diabetic cataract patients

Tang,

Duan

2024

World J Clin Cases

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BACKGROUND Diabetic patients with cataracts encounter specific difficulties during cataract surgery due to alterations in microcirculation, blood supply, metabolism, and the microenvironment. Traditional phacoemulsification may not fully tackle these issues, especially in instances with substantial preoperative astigmatism. The utilization of femtosecond laser-assisted phacoemulsification, in conjunction with Toric intraocular lens (IOL) implantation, offers a potentially more efficient strategy. This research seeks to evaluate the efficacy and possible complications of this approach in diabetic cataract patients. AIM To investigate the clinical efficacy and complications of femtosecond laser-assisted phacoemulsification combined with Toric IOL implantation in diabetic cataract patients, comparing it with traditional phacoemulsification methods. METHODS This retrospective study enrolled 120 patients with diabetes cataract from May 2019 to May 2021. The patients were divided into two groups: the control group underwent traditional phacoemulsification and Toric IOL implantation, while the treatment group received Len Sx femtosecond laser-assisted treatment. Outcome measures included naked eye vision, astigmatism, high-level ocular phase difference detection, clinical efficacy, and complication. RESULTS There were no significant preoperative differences in astigmatism or naked eyesight between the two groups. However, postoperative improvements were observed in both groups, with the treatment group showing greater enhancements in naked eye vision and astigmatism six months after the procedure. High-level corneal phase difference tests also indicated significant differences in favor of the treatment group. CONCLUSION This study suggests that femtosecond laser-assisted phacoemulsification combined with Toric IOL implantation appears to be more effective in enhancing postoperative vision in diabetic cataract patients compared to traditional methods offering valuable insights for clinical practice.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy of femtosecond laser-assisted phacoemulsification in diabetic cataract patients

Tang,

Duan

2024

World J Clin Cases

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“…CSME was defined by the presence of intraretinal cysts associated with CFT of 598 µm, which was equivalent to >30% thicker than normal values. Patients with DME had a significantly longer history of DM, but no significant difference between gender or age groups was identified ( 13 ). More importantly, among the 3,657 patients, the prevalence of DME was 5.4%.…”

Section: Association Of Dme and Cataract Surgerymentioning

confidence: 99%

“…Hispanics and Middle Easterners who are diabetic showed higher susceptibility toward DR than Asians. In this regard, an Italian study group showed that among 745 diabetic patients undergoing phacoemulsification, NPDR, PDR, and laser-treated retinopathy were present in 101 (14.3%), 13 (1.7%), and 53 (7.5%) patients, respectively (12). Furthermore, there was a positive correlation between the duration of DM and the severity of DR (13).…”

Section: Epidemiology Of Diabetic Retinopathymentioning

confidence: 99%

Optimizing treatment for diabetic macular edema during cataract surgery

et al. 2023

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Diabetic macular edema (DME) causes visual impairment in diabetic retinopathy (DR). Diabetes mellitus is a global epidemic and diabetic individuals are at risk of developing DR. Approximately 1 in 10 diabetic patients suffers from DME, which is the commonest cause of vision-threatening DR at primary-care screening. Furthermore, diabetes predisposes to a higher frequency and a younger onset of cataract, which further threatens vision in DME patients. Although cataract extraction is an effective cure, vision may still deteriorate following cataract surgery due to DME progression or recurrence, of which the risks are significantly higher than for patients without concurrent or previous history of DME at the time of operation. The management of pre-existing DME with visually significant cataract is a clinical conundrum. Deferring cataract surgery until DME is adequately treated is not ideal because of prolonged visual impairment and maturation of cataract jeopardizing surgical safety and monitoring of DR. On the other hand, the progression or recurrence of DME following prompt cataract surgery is a profound disappointment for patients and ophthalmic surgeons who had high expectations for postoperative visual improvement. Prescription of perioperative anti-inflammatory eye drops is effective in lowering the risk of new-onset DME after cataract surgery. However, management of concurrent DME at the time of cataract surgery is much more challenging because DME is unlikely to resolve spontaneously even with the aid of anti-inflammatory non-steroidal or steroid eye drops. A number of clinical trials using intravitreal injection of corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) as first-line therapy have demonstrated safety and efficacy to treat DME. These drugs have also been administered perioperatively for the prevention of DME worsening in patients undergoing cataract surgery. This article reviews the scientific evidence to guide ophthalmologists on the efficacy and safety of various therapies for managing patients with DME who are particularly vulnerable to cataract surgery-induced inflammation, which disintegrates the blood–retinal barrier and egression of fluid in macular edema.

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“…Cataract also occurs at an earlier age in diabetics (Klein et al, 1995). Overall, up to 20% of cataract extractions are estimated to be performed on diabetic patients (Rossi et al, 2020). In addition to improving visual acuity (VA), it is also important to perform cataract surgery in diabetics with significant cataract, to facilitate adequate screening and treatment of diabetic retinopathy (DR).…”

Section: Introductionmentioning

confidence: 99%

Long‐term results of cataract surgery in type 2 diabetics, a 20‐year prospective longitudinal study

Mönestam

2023

Acta Ophthalmologica

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PurposeTo investigate the 20‐year outcome, in best‐corrected visual acuity (BCVA), and subjective visual function (VF‐questionnaire, VF‐14) after cataract surgery in type 2 diabetics, compared with non‐diabetics.Methods109 type 2 diabetics and 698 non‐diabetics, who had cataract surgery during 1 year at one institution, were included in this prospective, longitudinal, population‐based cohort study. BCVA and VF‐14 responses were recorded pre‐ and postoperatively, and every 5 years up to 20 years after surgery. Retinopathy was graded before surgery.ResultsThere was no significant difference between diabetics and non‐diabetics, in change in BCVA from 10 years or more after surgery, p = 0.45, p = 0.44 and p = 0.83, at 10, 15 and 20 years, respectively, as well as in self‐perceived visual function (VF‐14) at any time after surgery, p = 0.72, p = 0.20 and p = 0.78, 10–20 years, respectively.At any follow‐up, there was no significant difference in BCVA in relation to retinopathy level before surgery, p = 0.1 at 20 years. There was a trend from 10 years after surgery and onward that patients with no retinopathy at baseline lost fewer letters during the 20 years than diabetics with retinopathy. Patients with known type 2 diabetes at surgery had a significantly lower survival compared with the non‐diabetics at each follow‐up, p = 0.003.ConclusionIn surviving diabetics, BCVA and subjective visual function were retained in most cases up to 20 years after cataract surgery. Cataract extraction is effective in causing a sustainable improvement in visual function also in type 2 diabetics. Knowledge of these long‐term outcomes is essential when counselling diabetics for cataract surgery.

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Diabetes and diabetic retinopathy in patients undergoing cataract surgery: a prevalence study—DiCat study report #2

Cited by 10 publications

References 33 publications

Clinical efficacy of femtosecond laser-assisted phacoemulsification in diabetic cataract patients

Clinical efficacy of femtosecond laser-assisted phacoemulsification in diabetic cataract patients

Optimizing treatment for diabetic macular edema during cataract surgery

Long‐term results of cataract surgery in type 2 diabetics, a 20‐year prospective longitudinal study

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