Abstract
Objective: The purpose of the study was to compare post-operative visual outcome and complications after small incision cataract surgery (SICS) in diabetic and non-diabetic patients of cataract. Method:This was prospective comparative study of 60patients having diabetes and 60 patients having cataract with no diabetes mellitus undergoing SICS. All patients underwent complete ocular examination including best corrected visual acuity, slit lamp bio microscopy,and 90D examination preoperative and postoperatively at 1week,4 week, 6week,2 months, 6 months interval. Intraoperative and postoperative complications and best corrected visual acuity were noted. Result: Mean of best corrected visual acuity postoperatively was 6/36 in diabetic patients while it was 6/6 in non-diabetic patients. Patients with no retinopathy in diabetic group improved to 6/12-6/9, in non-proliferative diabetic retinopathy (NPDR) without maculopathy to 6/12-6/18, NPDR with maculopathy improved to 6/36, cases with proliferative diabetic retinopathy (PDR) with maculopathy had vision finger counting close to face and patients with PDR without maculopathy had vision 5/60-6/60.This value is statistically significant p=0.022.suggesting worsening of visual outcome after small incision cataract surgery in diabetic patients due to diabetic retinopathy. Also,postoperative complications were noticed more in diabetic patients than anothernon-diabetic group who underwent SICS. Conclusion: SICS is a safe procedure in diabetic patients and decreased vision is attributed to preoperative diabetic retinopathy and worsening of diabetic retinopathy after small incision cataract surgery and not with the procedure per se. Visual acuity are almost same in diabetes and non- diabetes except for late stage. Complications are found more in diabetic patients.
Highlights
Diabetes mellitus (DM) is one of the most prevalent non-communicable disease in the world and threat to public health
A total of 60 patients who were admitted with diminished vision due to cataract and found to be either known case of diabetes mellitus or detected to be diabetic during preoperative work up and rest of 60 pts having cataract with no systemic history were screened for inclusion and exclusion criteria
Our study showed similar result with posterior capsular opacity (PCO) rate more in diabetic
Summary
Diabetes mellitus (DM) is one of the most prevalent non-communicable disease in the world and threat to public health. DM can lead to several ocular complications such as diabetic retinopathy, diabetic papillopathy, glaucoma, cataract, and ocular surface diseases[1]. In older patients ocular symptoms are mainly of cataract others include refractive changes and retinopathy. Cataracts are disproportionately more likely to occur and their surgical correction more problematic in diabetic than in nondiabetic patients [3,4]. Newer techniques like phacoemulsification have made cataract surgery safe and predictable [5] in developing nations small incision cataract surgery is common procedure carried out as being more economical and with almost similar clinical outcome in terms of vision and complications [6]
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