Abstract
Diabetes mellitus is one of the most prevalent chronic diseases worldwide. Diabetic patients are at risk of developing cataract and present for surgery at an earlier age than non-diabetics. The aim of this study was to review the problems associated with cataract surgery in a diabetic patient. Corneal complications in diabetic patients include delayed wound healing, risk of developing epithelial defects or recurrent erosions due to the impairment of epithelial basement membranes and epithelial–stromal interactions. Diabetic patients present lower endothelial cell density and their endothelium is more susceptible to trauma associated with cataract surgery. A small pupil is common in diabetic patients making cataract surgery technically challenging. Finally diabetic patients have an increased risk for developing postoperative pseudophakic cystoid macular edema, posterior capsule opacification or endophthalmitis. In patients with pre-proliferative or proliferative diabetic retinopathy, diabetic macular edema or iris neovascularization adjunctive therapy such as an intravitreal anti-vascular endothelial growth factor injection, can inhibit exacerbation related to cataract surgery.
Highlights
Diabetes mellitus (DM) is one of the most prevalent and morbid chronic diseases, and affects millions of patients worldwide
We identified 116 eligible publications from the PubMed and Web of Science database
The changes in refraction should prompt strict glucose control, an advantage of cataract surgery is that variations in refraction will be eliminated
Summary
Diabetes mellitus (DM) is one of the most prevalent and morbid chronic diseases, and affects millions of patients worldwide. As diabetic patients have an increased risk of developing cataract, being susceptible to develop cortical and posterior subcapsular opacities, they present for surgery at an earlier age [1]. The relative risk of developing cataract increases with the duration of diabetes, severity of hyperglycemia and age [2]. Accumulation of advanced glycation end products (AGE) in the lens is one of the mechanisms of diabetic cataract development [3]. Cataract surgery in diabetic patients carries a higher risk of both intraoperative and postoperative complications compared to non-diabetic patients [4,5]. The aim of this study was to review the problems associated with cataract surgery in diabetic patients
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