Abstract

Extracapsular cataract extraction with posterior chamber intraocular lens in 24 eyes of 24 diabetics, with and without diabetic retinopathy, were followed up postoperatively for an average of 14 months to determine the incidence of progression of diabetic retinopathy, the final visual acuity and factors predictive of progression of retinopathy and final visual acuity. Overall, retinopathy progressed in 52% of operated-on eyes. Cataract extraction was highly associated with progression of diabetic retinopathy. Women had a significantly increased risk of progression of retinopathy in the operated-on eye compared to men. Visual acuity improved in 22 of 24 orerated-on eyes : however, only 11 eyes achieved a visual acuity of 0.5 or better and only 7 eyes achieved a visual acuity of 0.7 or better. Patients treated with oral hypoglycemic agents had a worse visual prognosis than those treated with insulin. The prognosis of patients with diabetic retinopathy about to undergo cataract surgery, even extracapsular cataract extraction with placement of a posterior chamber lens, is guarded.

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