Cataract surgery beneficial even in diabetics
MedWire News: Diabetic status does not diminish 5-year visual outcomes of individuals who undergo cataract surgery, according to Swedish study results.
"Our data suggest that phacoemulsification is beneficial in terms of visual and functional improvement in diabetics with significant cataract," say Britta Lundqvist and Eva Mönestam, from Norrlands University Hospital in Umeå.
They add: "Diabetics still alive 5 years after surgery do not have a significantly worse [visual function and visual acuity] outcome compared with nondiabetics."
The population-based study involved 57 cataract patients with diabetes and 473 without diabetes. The patients had a mean age of 72 years and all underwent objective and subjective assessment of visual acuity pre- and postoperatively.
Objective assessment was achieved by visual acuity testing and subjective assessment was performed via patient completion of a visual function questionnaire (VF-14; scores out of a maximum of 100, which reflects no visual complaints).
The findings, published in the journal Acta Ophthalmologica, show no significant difference in subjective visual function among diabetics and nondiabetics at 4 months and 5 years postoperatively.
Specifically, a median 4-month VF-14 score of 100 was observed among patients with and without diabetes. At 5 years postoperatively, this score was 96.4 and 97.2 among diabetics and nondiabetics, respectively.
A similar trend was seen for median best corrected visual acuity (BCVA) outcomes at 4 months and 5 years postoperatively. The median BCVA at postoperative month 4 was 0.046 log of the minimum angle of resolution (log MAR) among both diabetics and nondiabetics, and 0.140 and 0.100 logMAR for diabetics and nondiabetics, respectively, at 5 years postoperatively.
At baseline, 32% of all diabetic patients had evidence of diabetic retinopathy on fundoscopy. This increased to 56% by 5 years after surgery.
Despite the presence of diabetic retinopathy among more than half of the diabetic patients, a similar proportion of diabetics and nondiabetics reported a 10-point fall in VF-14 between 4 months and 5 years postoperatively.
During this time, a loss of at least 0.1 logMAR in BCVA was also observed among approximately 30% of diabetics and nondiabetics.
Lundqvist and Mönestam conclude that in light of similar long-term objective and subjective patient outcomes, irrespective of diabetes status, diabetes should not be considered a limiting factor of cataract surgery outcomes.
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By Lauretta Ihonor