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Robert A. Mittra, MD; Jesus L. Borrillo, MD; Sundeep Dev, MD; William F. Mieler, MD; Steven B. Koenig, MD

Arch Ophthalmol. 2000;118:912-917.

Objectives  To determine the rate of progression of diabetic retinopathy after phacoemulsification surgery, and whether surgeon experience and/or surgical duration adversely affect visual outcome.

Methods  A retrospective review of 150 eyes of 119 diabetic patients who underwent phacoemulsification surgery during a 5-year period was performed. Data collected included patient age, sex, type and duration of diabetes, diabetic control, associated systemic health factors, preoperative visual acuity and retinopathy grade, duration of surgery, intraoperative complications, and postoperative course. The effect of these factors on visual outcome and rate of retinopathy progression was studied by means of univariate and stepwise multivariate logistic regression analyses. Resident and private cases were compared.

Results  Visual acuity improved by 2 or more lines in 117 eyes (78%); 93 eyes (62%) had a final visual acuity of at least 20/40. Retinopathy progression was seen in 37 eyes (25%) with 6 to 10 months of follow-up. Preoperative nonproliferative diabetic retinopathy, proliferative diabetic retinopathy, and limited surgical experience were statistically associated with retinopathy progression and poor visual outcome.

Conclusions  The visual results and rate of retinopathy progression after phacoemulsification surgery in our series did not differ significantly from those reported that used other techniques. Nonproliferative and proliferative diabetic retinopathy and surgical inexperience resulted in an increased rate of retinopathy progression.

From the Department of Ophthalmology, Eye Institute, Medical College of Wisconsin, Milwaukee (Drs Mittra, Borrillo, Dev, Mieler, and Koenig); and Retina Associates of Cleveland, Cleveland, Ohio (Dr Mittra). Dr Mieler is now with the Cullen Eye Institute, Baylor College of Medicine, Houston, Tex.

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