Cataract Surgery May Increase the Progression of Diabetic Retinopathy, Study Warns

Procedure can still be useful if doctors focus on early detection and controlling patients’ blood sugar levels, researchers indicate.

A new study suggests that type 2 diabetes patients may face a higher risk of vision complications during the year after undergoing cataract surgery, including the development of diabetic retinopathy, bleeding in the eye or retinal detachment in one or both eyes.

According to findings published in the journal Ophthalmology on February 14, researchers from the Jones Eye Institute at the University of Arkansas indicate that cataract surgery may cause inflammation in the eyes of diabetics, which can result in the development or progression of diabetic retinopathy.

Cataract surgery is a fairly common procedure that removes the eye’s lens and replaces it with an artificial lens to remove cloudy spots impairing vision. The patient’s eye is numbed before the incision and the cataract is removed. Patients can suffer side effects like swelling, bleeding, infection and vision loss.

Diabetics can develop cataracts from consistently high blood sugar, which can damage the eyes in many ways over time. The most common damage is in the form of diabetic retinopathy. Proliferative diabetic retinopathy is a late-stage form that causes new blood vessels to grow on the retina and can cause blindness if left untreated.

For this study, a research team led by Dr. Ahmed Sallam analyzed healthcare data from the TriNetX United States Collaborative research network. The data included patients 18 years or older with type 2 diabetes and non-proliferative diabetic retinopathy. Patients either underwent routine cataract surgery, or did not, and were matched with control subjects.

According to the findings, patients with type 2 diabetes had a higher risk of developing proliferative diabetic retinopathy if they had cataract surgery. The procedure also appeared to increase the risks of eye bleeding and retinal detachment, researchers noted.

Among 7,200 patients, more than 50% of those who had cataract surgery experienced one of the side effects within one year after surgery. The risk of eye bleeding was higher than retinopathy and retinal detachment overall.

Prior research indicates just having diabetes doubles the risk of cataracts and increases the risks of complications after cataract surgery already.

Sallam’s team said it is possible cataract surgery creates inflammation in the eye, which may promote and accelerate retinopathy and other side effects.

Monitoring for Retinopathy After Cataract Surgery

Even though cataract surgery retinopathy may cause irreversible vision loss, researchers noted the procedure still offers patients potential benefits if successful, including improved vision and improved quality of life.

Instead of avoiding cataract surgery, researchers said doctors should focus on earlier detection and treatment to help improve the risk and lead to better outcomes.

They also recommended doctors follow up early with patients and conduct consistent examinations after cataract surgery to help with early diagnosis and treatment if retinopathy occurs. The researchers encourage patients to work with their doctor to help control their diabetes, to further reduce their risk of retinopathy and vision loss.