Comparison of Visual Recovery after Phacoemulsification in Patients with and without Diabetes Mellitus: A Prospective Comparative Study

Abstract

Background: Diabetes mellitus is common among patients undergoing cataract surgery and may influence postoperative visual recovery through ocular surface changes, macular pathology, diabetic retinopathy and altered wound healing. This study was designed to compare early and intermediate visual recovery after uncomplicated phacoemulsification in patients with and without diabetes mellitus.

Methods: This prospective comparative study was structured for 200 adult patients undergoing uncomplicated phacoemulsification with posterior chamber intraocular lens implantation at the Department of Ophthalmology, Prakash Institute of Medical Sciences, Urun-Islampur. One hundred patients with diabetes mellitus constituted Group A and 100 age-comparable patients without diabetes constituted Group B. Best-corrected visual acuity (BCVA), recorded as logarithm of the minimum angle of resolution (logMAR), was assessed preoperatively and on postoperative day 1, week 1, month 1 and month 3. Diabetic status, HbA1c, diabetic retinopathy and postoperative clinical findings were also recorded. Statistical analysis used independent-samples t tests and chi-square tests as appropriate.

Results: Mean age was 63.2±6.8 years in the diabetes group and 62.0±6.7 years in the non-diabetes group. Mean BCVA improved progressively in both groups. At 3 months, mean BCVA was 0.11±0.10 logMAR in the diabetes group and 0.09±0.08 logMAR in the non-diabetes group (p=0.013). The mean improvement from baseline to 3 months was 0.75±0.20 and 0.77±0.19 logMAR, respectively (p=0.659). Transient postoperative corneal edema was observed in 16% and 8% of patients, respectively.

Conclusion: Patients with and without diabetes demonstrated substantial visual improvement following uncomplicated phacoemulsification. The diabetic group showed slightly slower early recovery, while the difference in mean BCVA at 3 months was small. Larger studies incorporating diabetic retinopathy and glycaemic control may better define factors associated with delayed recovery.