Several Factors Influencing VA Outcomes After Cataract Surgery in Patients With Type 2 Diabetes


The authors report no relevant financial disclosures.

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Important points:

  • Two-thirds of diabetics achieved visual acuity of 20/40 or better after cataract surgery.
  • Preoperative visual acuity and diabetic retinopathy were associated with visual outcome.

The prognosis for vision after cataract surgery is usually good, but factors such as diabetic retinopathy can limit vision in people with type 2 diabetes, a published study finds. I was. British Journal of Ophthalmology.

“This is one of the largest studies evaluating VA outcomes in diabetic patients undergoing cataract surgery.” Deborah Lee From the Department of Epidemiology and Clinical Applications of the National Eye Institute, and written by colleagues. “Furthermore, this study provides an up-to-date benchmark for the prevalence of favorable visual outcomes after cataract surgery in modern diabetic patients.”

cataract eye 1

Outcomes of cataract surgery were influenced more by ocular parameters than by systemic parameters. Image: Adobe Stock

Researchers from the National Eye Institute and Wake Forest University conducted a retrospective study of type 2 diabetes patients enrolled in the multicenter randomized Behaviors to Control Cardiovascular Risk in Diabetes (ACCORD) study and the ACCORD Eye Substudy. We conducted a case-control study. They evaluated his 1,136 eyes in his 784 participants (mean age 65.6 years, 58.4% male) who underwent cataract surgery between 2001 and 2014.

Of a subsample of 362 eyes from 251 patients who received gradeable fundus photography for diabetic retinopathy, 49.4% had no diabetic retinopathy and 13.8% had mild nonproliferative diabetic retinopathy. (NPDR), 34.3% had moderate NPDR and 0.8% had severe NPDR. 1.7% had proliferative diabetic retinopathy.

Results showed that 762 eyes (67.1%) achieved a good visual outcome of at least 20/40, and of the subset that underwent fundus photography, 265 eyes (73.2%) achieved a good outcome.

Significant predictors of favorable visual outcome included high level of education (OR = 2.35), bilateral cataract surgery (OR = 1.55) and preoperative visual acuity (OR = 10.59). In a subsample of 362 eyes, the presence or absence of diabetic retinopathy also affected visual outcome (OR = 1.73).

Factors not significantly associated with visual acuity outcomes, including age, gender, race, smoking, duration of diabetes, blood pressure, lipid levels, and HbA1C, were:

“Notable factors associated with visual outcome included preoperative VA and diabetic retinopathy, but not HbA1C. Socioeconomic status and related issues were also important. It can be a consideration,” Lee and colleagues wrote.

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