EASDEC European Association for the Study of Diabetic Eye Complications
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EASDEC European Association for the Study of Diabetic Eye Complications |
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Abstracts: Flesner P. Flesner (PF)1, B. Sander (BS)1 ,V. Henning (VH)1, H-H. Parving (HHP)2, H. Lund-Andersen (HLA)1. 1 Dept. of Ophthalmology, Herlev Hospital, University of Copenhagen, Denmark. 2Steno Diabetes Center, Gentofte, Denmark. Cataract surgery in diabetic patients. An evaluation of lenfluorescence and blood-aqueous-barrier (kd) as risk indicators for postoperative progression of diabetic retinopathy and macular oedema.Purpose To evaluate the visual outcome, the rate of progression of diabetic retinopathy (DR) and macular oedema (MO) in diabetic patients after cataract surgery done with phacoemulsification by the same experienced surgeon and with implantation of a surface coated intraocular lens (Pharmacia/Upjohn 809C). The fellow eye served as control during a 6 months follow-up period. As possible preoperative risk indicators, lens fluorescens and the blood-aqueous-barrier (kd) were evaluated. Results39 patients were included and completed the follow-up. Postoperatively 6/39 patients progressed in DR and 4/39 developed a MO in the eye operated on and not in the control eye. Cataractsurgery implies an increased relative risk (1.7, p=0.04) of postoperative progression of DR and development of MO compared to the control eye. All unilateral MO´s developed after more than three months of observation. Neither lensfluorescence, BAB, HbA1c, level of retinopathy, diabetestype, duration of diabetes, diabetes treatment or antihypertensive treatment differed significantly. However, lensfluorescence was the parameter closest to a significant elevation in the former patientgroup. Accuracytesting of lensfluoresence and kd proves good specificity and negative predictive value but poor sensitivity and positive predictive value. ConclusionDiabetes and DR should not be regarded as a contraindication to cataract surgery. Patients should be operated on when DR is in a quiescent state and any need for retinal photokoagulation is sufficiently supplied. Postoperatively controls should last until 6 months after surgery. Lens fluorescence might be but BAB probably not predictive when evaluating the postoperative risk of progression of retinopathy or developing macular oedema. |
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