Cataract Surgery May Worsen Diabetic Retinopathy
How Many Intraocular Injections (eg Avastin) Are Too Many?
August 27, 2009Using Avastin for ARMD, A True Success Story
September 1, 2009This post will be short and is written as follow-up to “Diabetics Get Cataracts”.
There is a study just published in the journal Ophthalmology where patients with diabetes underwent cataract surgery. The incidence of diabetic retinopathy was then followed for at least 12 months. Patients with both Type I and Type II diabetes were followed.
Overall, there was an increased incidence of diabetic retinopathy in the eyes of those patients that underwent cataract surgery versus the eyes that did not have cataract surgery. In addition, in 45 patients where only one eye was operated upon, there was an increased chance of developing diabetic retinopathy in the operated eye.
What does this mean? This seems to underscore the importance of having cataract surgery earlier than later, that is, have cataract surgery when the retinopathy is either not detectable or barely detectable. Also, this study included patients 65 years or older. The results did not follow the visual acuity. Lastly, even though the incidence of diabetic retinopathy increased, the results indicate better outcomes than similar studies using older cataract surgery techniques (i.e. newer techniques are better and safer). The newer “phacoemulsification” techniques are quite common in the U.S. and have been so for about 10-15 years.
The abstract to the article.
“Randy”
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
www.TotalRetina.com
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5 Comments
Would an extra NSAID eye drop help lessen the risk of worsening their diabetic retinopathy?
This is a good point. Although it is becoming clearer that chemical mediators, such as VEGF, are involved in developing macular edema, and likely the development of diabetic retinopathy, it is less clear what triggers this chain of events after cataract surgery.
Clinically, doctors have been using NSAIDS to combat macular edema after cataract surgery. Presumably, this interrupts some chemical pathway involving prostaglandins. Whether or not this is similar to the development of diabetic retinopathy after cataract surgery, I don’t know.
It is a very good idea.
I hope this was helpful.
Randy
[…] V. Wong, M.D. explains in a recent blog posting that “this seems to underscore the importance of having cataract surgery earlier than later, that […]
I have had detached retinas in both eyes. I had surgery several years ago…”sceleral buckles” were installed & laser treatment performed to fix the tears. I had to have follow-up surgery to loosen the bands a couple of years later. My lateral rectus muscle was affected when this surgery was performed. I developed “double-vision” years later due to this surgery (I didn’t find out this was the problem until I had surgery to move the muscle to give me single vision straight ahead). I had cataract surgery a few years ago in my right eye & a “macular pucker” was discovered. I now have distorted vision in this eye & a continuous “pulsing.” The vision is clearer than the left eye, but since I can’t really use both eyes together (due to the former muscle problem), it doesn’t help my vision. I was told they could try to correct the macular pucker (80% chance of success), but no one has determined why I have the continuous pulsing in this eye. I am afraid to have the left eye cataract corrected, as I could lose what vision I have in that eye which is my primary source for my vision. I have a question as to why they didn’t realize I had a macular pucker before the cataract surgery & why I still have the pulsing in this eye. Can cataract surgery cause a macular pucker? I have Type II Diabetes and currently taking pills for treatment (no injections, as yet). I need assistance as to how to proceed w/the left eye & what can be done about the pulsing in my right eye. I have not decided not to try to correct the macular pucker at this time. I am not sure the surgery would be beneficial. I could use any advice you can give me.
Patrick,
Wow!
Let me try;
1. Macular pucker can develop after cataract surgery.
2. Diabetic retinopathy may also be a contributing factor, but I can’t tell.
3. I have no idea about the pulsing vision.
Find someone you trust and get a second/third opinion.
randy