Extracapsular cataract surgery with posterior chamber lens implantation in patients with diabetes mellitus - retrospective study on 145 patients

The purpose of this paper is to investigate whether cataract surgery in patients with diabetes mellitus influences the progression of diabetic retinopathy, diabetic macular oedema and anterior segment complications. 145 consecutive patients with type-II-diabetes mellitus underwent an extracapsular cataract surgery with implantation of a posterior chamber lens. 88 patients (119 eyes have been operated) could be followed up for an average of 19 months and 58 patients (88 eyes have been operated) could be followed up for an average of 38 months. Evaluation of the data included the preoperative retinal findings, intraoperative and early postoperative complications and problems, the progression of diabetic fundus changes, the progression of visual acuity and late complications. Insufficient pupil dilatation (25.2 %) was the most frequent intraoperative complication. Among early postoperative complications anterior segment inflammation was most frequent (10.1 %). During the follow-up period the diabetic retinopathy in the operated eyes showed a progression which was statistically not different from that in the non-operated eyes. After an average of 19 months the diabetic retinopathy deteriorated in 22.7 % of the operated eyes and in 17.5 % of the non-operated eyes. After an average of 38 months the diabetic retinopathy deteriorated in additional 12.5 % of the operated and 11.1 % of the not-operated eyes. A diabetic macular oedema was present after an average of 19 months in 6.8 % of the operated 119 eyes and after an average of 38 months in 6.7 % of the operated 88 eyes. In the non-operated partner-eyes no diabetic macular edema developed during the follow-up period. The main late-complication during the whole follow-up period was the development of a capsular fibrosis in 52.3 % of the operated eyes. Postoperative visual acuity at the end of the first follow-up period (average 19 months) was >/= 0.5 in 85.7 % of the operated eyes and at the end of the second follow-up period (average 38 months) in 81.8 % of the operated eyes. Extracapsular cataract surgery in patients with diabetes mellitus is a procedure with good results, of high reliability and a slightly higher rate of complications than in non-diabetic patients. Extracapsular cataract surgery does not give rise to progression of diabetic retinopathy.