The impact of phacoemulsification cataract surgery on eyes previously treated by laser photocoagulation for diabetic retinopathy

Abstract

to evaluate the evolution of diabetic retinopathy (DR) after cataract surgery on eyes previously treated by photocoagulation for DR. The compensation of glycaemia (glycosylated haemoglobin, HbA1c) and prevalence of attendant diseases (hypertension, ischemic heart disease and alteration of lipid metabolisms) were evaluated. Forty eyes (40 patients) were evaluated, of which ten (25 %) eyes with DR were treated without laser photocoagulation (LK), and 30 (75 %) eyes were previously treated by LK. Two criteria for evaluating the stabilisation were used, particularly the best corrected visual acuity (BCVA) and the necessity of additional laser photocoagulation. As many as 100 % of eyes without LK and 86.7 % of eyes with LK had BCVA improved on the first day after surgery (p ≤ 0.05). The BCVA of 0.5 or better was achieved in 31 eyes (77.5 %). The mean level of HbA1c in group without LK was 7.09 ± 1.21 %; in group after LK it was 7.36 ± 1.64 %. The mean level of HbA1c in the group with stable BCVA was 7.14 ± 0.46 % and the duration of DM was 18.6 ± 2.93 years. HbA1c, in group of eyes with worsened BCVA, was 7.86 ± 2.23 %, and the duration of DM was 21.0 ± 8.54 years. HbA1c in the group of stable eyes (without LK after surgery) was 6.71 ± 0.1 %, and the duration of DM was 17.84 ± 8.97 years. HbA1c, in group, where additional LK was applied, was 7.56 ± 0.69 %, and the duration of DM was 19.54 ± 3.26 years. The difference in levels of HbA1c was statistically significant (p ≤ 0.1). The prevalence of attendant disease was highest in the group of eyes with worsened BCVA and necessity of additional LK. The results of study confirm an improvement in BCVA after cataract surgery by phacoemulsification in the most of patients. Better stabilisation of glycaemia levels and lower frequency of internal diseases were in group with stable BCVA and without necessity of additional LK after cataract surgery (Tab. 3, Fig. 1, Ref. 28).