Clinical and Experimental Ophthalmology
May 2020

Outcomes of cataract surgery in eyes with diabetic macular oedema: Data from the Fight Retinal Blindness! Registry

Sanjeeb Bhandari, Anne C Biechl, Vuong Nguyen, David Squirrell, Hemal Mehta, Daniel Barthelmes, Mark C Gillies


Importance: There are limited data on real-world outcomes of cataract surgery in eyes receiving intravitreal treatments for diabetic macular oedema (DMO).

Background: Cataract surgery may exacerbate oedema in some eyes with DMO resulting in inferior outcomes.

Design: Matched, case-controlled retrospective study of observational data in routine clinical practice.

Participants: Eyes receiving intravitreal treatments for DMO tracked in the Fight Retinal Blindness! Registry.

Methods: Eyes that underwent cataract surgery were identified and matched 1:1 with phakic controls also receiving intravitreal injections for DMO. We also assessed potential factors that were associated with better visual acuity (VA) outcomes.

Main outcome measures: Change in VA 6 months after cataract surgery.

Results: Cataract surgery was identified in 208 eyes of 156 patients of which 147 eyes had 6 months of observations before and after surgery. The mean VA 6 months after surgery improved by 10.6 letters and was similar to their matched phakic controls (68.8 vs 69.2 letters; P = 0.8). Mean CST both 6 months before (341 μm) and after (360 μm) surgery were similar (P = 0.08). However, these eyes had thicker maculae and they received more injections than their matched phakic controls both before and after surgery. Eyes with worse VA before surgery and those that had received intravitreal treatment in the 4 weeks preceding surgery were more likely to gain vision.

Conclusions and relevance: Visual outcomes of cataract surgery in eyes receiving intravitreal therapy for DMO were reasonably better. Their maculae were thicker and required more injections in the 6 months before and after surgery than their phakic controls.