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Treating Active Diabetic Retinopathy Before Cataract Surgery Can Lower Risk of Progression SAN FRANCISCO -- July 31, 2009 -- A study published in this month’s journal of Ophthalmology describes methods that could make cataract surgery safer for older patients with diabetic retinopathy, such as treating active diabetic retinopathy before cataract surgery to lower risk of progression. Before 1996, retinopathy often developed or progressed rapidly in diabetic patients following cataract surgery. In the past decade the less-invasive phacoemulsification method has reduced cataract surgery complications in general, but the impact on diabetic retinopathy has been unclear. A clinic-based cohort study (2004-2006) led by Jie Jin Wang, PhD, Centre for Vision Research, University of Sydney, Sidney, Australia, followed 169 patients with diabetes aged 65 years and older for 12 months post-cataract surgery. Of the patients, 45 had surgery in just 1 eye. Overall, diabetic retinopathy developed or progressed in about one-third of operated eyes compared with about one-fifth of non-operated eyes. In the 45 patients for whom fellow eye comparisons were made, diabetic retinopathy progressed in 35.6% of operated eyes versus 20% of non-operated eyes. Research on older cataract surgery methods had reported diabetic retinopathy progression in 37% to 38% of eyes within 12 to 18 months of surgery; phacoemulsification is somewhat less likely to stimulate diabetic retinopathy progression, the new study suggests. Dr. Wang cautions that patients who need cataract surgery may simply be at greater risk for diabetic retinopathy progression, because both conditions are related to poor control of diabetes. Cataract may be a marker for greater diabetic retinopathy severity or increased risk of progression. “Although our results should not argue against cataract surgery in older people with diabetes, clinicians need to recognise the diabetic retinopathy risk, treat active diabetic retinopathy preoperatively -- for example, use laser treatment to control macular edema -- and closely monitor diabetes and diabetic retinopathy after cataract surgery,” Dr. Wang said. SOURCE: American Academy of Ophthalmology E-mail this page to a friend or colleague! To print, use this version