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Review
. 2019 May 20;8(5):716.
doi: 10.3390/jcm8050716.

Diabetes and Phacoemulsification Cataract Surgery: Difficulties, Risks and Potential Complications

Andrzej Grzybowski  1   2 , Piotr Kanclerz  3 , Valentín Huerva  4 , Francisco J Ascaso  5   6 , Raimo Tuuminen  7   8
Affiliations
Review

Diabetes and Phacoemulsification Cataract Surgery: Difficulties, Risks and Potential Complications

Andrzej Grzybowski et al. J Clin Med. .

Abstract

Diabetes mellitus is one of the most prevalent chronic diseases worldwide. Diabetic patients are at risk of developing cataract and present for surgery at an earlier age than non-diabetics. The aim of this study was to review the problems associated with cataract surgery in a diabetic patient. Corneal complications in diabetic patients include delayed wound healing, risk of developing epithelial defects or recurrent erosions due to the impairment of epithelial basement membranes and epithelial-stromal interactions. Diabetic patients present lower endothelial cell density and their endothelium is more susceptible to trauma associated with cataract surgery. A small pupil is common in diabetic patients making cataract surgery technically challenging. Finally diabetic patients have an increased risk for developing postoperative pseudophakic cystoid macular edema, posterior capsule opacification or endophthalmitis. In patients with pre-proliferative or proliferative diabetic retinopathy, diabetic macular edema or iris neovascularization adjunctive therapy such as an intravitreal anti-vascular endothelial growth factor injection, can inhibit exacerbation related to cataract surgery.

Keywords: cataract surgery; diabetes mellitus; diabetic macular edema; diabetic retinopathy; phacoemulsification.

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Conflict of interest statement

Grzybowski reports non-financial support from Bayer, non-financial support from Novartis, non-financial support from Alcon, personal fees and non-financial support from Valeant, grants from Zeiss, personal fees and non-financial support from Santen, outside the submitted work. Kanclerz reports non-financial support from Visim and Optopol Technology. Huerva reports non-financial support from Bausch & Lomb, outside the submitted work. Ascaso reports non-financial support from Alcon, Novartis, Topcon and Zeiss, personal fees and non-financial support from Allergan and Bayer, outside the submitted work. Tuuminen reports non-financial support from Bayer, personal fees from Novartis and Allergan, personal fees from Alcon, non-financial support from Thea, outside the submitted work.

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