November is Diabetes Awareness Month – 30 days dedicated to bringing attention to the diabetes epidemic and educating the millions of people who are at risk of developing the disease. Because people with type 1 and type 2 diabetes are at a higher risk for developing cataracts, we examine the impact of diabetes on cataract surgery.
What Do Eye Doctors Look for in Patients with Both Diabetes and Cataracts?
Although anyone can develop a cataract, people with diabetes tend to get them at a younger age. Also, cataracts in people with diabetes may get worse at a faster pace. When vision becomes impaired to the extent that cataract surgery is required, the process may be more complicated for people who have both diabetes and cataracts. To start, the evaluation process for cataract surgery can be more extensive.
When it comes to a preoperative examination, eye doctors will perform a more in-depth assessment that includes more tests. Before performing cataract surgery, a doctor will want to know that vision loss is due to the cataract and not due to other causes related to diabetes. For example, some diabetic patients develop a condition known as diabetic retinopathy, which occurs when high blood sugar levels cause damage to the blood vessels in the retina. Because of this, an eye doctor may request that a retina specialist also perform an examination as a part of the cataract surgery evaluation process. If vision loss is being exacerbated by a secondary condition, an eye doctor may recommend developing a treatment plan for that condition first and delaying cataract surgery.
Cataract Surgery Factors Eye Doctors Will Consider
When a patient has both diabetes and cataracts, doctors have more factors to consider when it comes to performing cataract surgery. For example, if the patient’s blood glucose levels are too high, the doctor may recommend delaying surgery until the diabetes is better controlled.
Conversely, sometimes eye doctors will recommend performing cataract surgery at an earlier stage in cataract development to lessen the risks of complications. Also, because cataract surgery can lead to the progression of diabetic retinopathy, for patients who are experiencing minimal impacts to the eyes due to diabetes, performing surgery at an earlier stage may be preferable.
Cataract surgery involves removing the natural lens of the eye and replacing it with an artificial lens known as an intraocular lens or IOL. Certain types IOLs need to be avoided in patients who have diabetes, adding another factor that doctors need to consider.
How Diabetes Affects Cataract Surgery Recovery
Patients with diabetes who undergo cataract surgery may need closer supervision after surgery. They may also be prescribed medications to prevent and treat swelling, inflammation, and the buildup of fluid (macular edema).
There is also a higher risk for developing a condition known as posterior capsule opacification (PCO), commonly known as “secondary cataract.” Despite what the name implies, it’s not actually a cataract. PCO is a complication of cataract surgery where the capsule that holds the eye’s lens becomes opaque, or cloudy. Fortunately, it can usually be treated with a routine laser procedure.
Although cataract surgery is a common procedure, it can be associated with complications in people with diabetes. There are many factors for an eye doctor to consider, but with a thorough pre-surgical evaluation along with careful treatment before and after surgery, many people with diabetes achieve good results from cataract surgery.
Resources:
https://www.diabetes.org/diabetes/complications/eye-complications
https://www.webmd.com/diabetes/diabetes-eye-problems
https://retinatoday.com/articles/2010-july-aug/cataract-surgery-in-diabetic-patients
