Impact of Delayed Sequential Bilateral Cataract Surgery on Diabetic Macular Edema: A Real‐World Study in Northwestern China

Abstract

Objectives. To assess the incidence and characteristics of treatment‐requiring diabetic macular edema (TR‐DME) in eyes after delayed sequential bilateral cataract surgery in patients with diabetes mellitus. Methods. This was a retrospective study involving patients with diabetes who underwent cataract surgery at Shaanxi Eye Hospital between January 2019 and December 2021. The incidence and characteristics of a first episode of TR‐DME after delayed sequential bilateral cataract surgery were observed. Results. A total of 1553 individuals (3106 eyes) were included in the study. All patients underwent bilateral cataract surgery with the prescribed interval of surgery within one month. The incidence of TR‐DME was 0.52% in the year before surgery versus 1.87% in the year after surgery (p < 0.05). The highest risk period was between 2 and 4 months after surgery. A first episode of TR‐DME was observed in 58 eyes of 35 patients after delayed sequential bilateral cataract surgery. The patients were divided into four groups according to the interval between bilateral cataract surgeries. A higher incidence of TR‐DME was observed when the interval between the surgeries was less than two weeks. Conclusions. This is the first real‐world study of the effects of cataract surgery on the development of TR‐DME. The study was performed at the largest ophthalmic center in Northwestern China. The findings demonstrate that the incidence of TR‐DME increased significantly after cataract surgery, with the highest incidence between two and four months after surgery. Patients with shorter intervals between bilateral cataract surgeries were at a high risk.