PHOTIC RETINOPATHY AFTER CATARACT SURGERY IN DIABETIC PATIENTS

Abstract

To report and emphasize photic retinopathy (PR) after cataract surgery in diabetic patients. The charts of 2,573 patients who underwent cataract surgery at Baskent University Hospital (Ankara, Turkey) between January 2001 and December 2003 were retrospectively analyzed for PR and diabetes mellitus (DM). All surgeries were performed using the same coaxial illuminated microscope. The diagnosis of PR was confirmed by fluorescein angiography, showing typical mottled fluorescein transmission in a well circumscribed area in each case. Statistical analyses were performed with chi2 and Mann-Whitney U tests. Diagnoses of PR and DM were established in 16 cases (0.62%) and 382 cases (14.85%), respectively. DM was present in 7 (43.75%) of the PR cases. PR occurred more frequently in DM patients than in non-DM patients (7/382 vs. 9/2,191, respectively; P = 0.001; chi2= 10.64). All 16 patients with PR had received retrobulbar anesthesia (RA). RA was used in 61.21% of all surgeries and in 78.01% of the surgeries for DM patients. Occurrence of PR during RA was higher for DM patients than for non-DM patients (7/298 vs. 9/1,277, respectively; P = 0.011; chi2= 6.50). Mean operation times +/- SD for PR cases were 29.9 +/- 9.9 minutes and 38.2 +/- 5.3 minutes in DM and non-DM cases, respectively (P = 0.091). None of the photic lesions were sight threatening. Diabetic patients may be more vulnerable to photic injury. Surgeons should take precautions to prevent PR when performing cataract surgery on diabetic patients.