Abstract
Purpose Cataract surgery in the presence of active proliferative diabetic eye disease carries a high risk of progression of retinopathy and neovascular glaucoma. Lens opacities may prevent panretinal photocoagulation (PRP) before surgery, and applying PRP in the immediate post-operative period can be difficult. The purpose of this study is to report results of cataract extraction combined with per-operative indirect laser PRP in a group of these patients.
Methods Nine eyes of 9 diabetic patients with active retinal or iris neovascularisation in which lens opacities prevented adequate pre-operative PRP underwent cataract surgery combined with indirect laser PRP after cortex aspiration and before intraocular lens implantation.
Results Regression of neovascularisation with this combined procedure alone was achieved in 5 eyes, 3 responded to further PRP, and 1 developed neovascular glaucoma. Visual acuity improved in all eyes, 4 achieving ≥6/12. Four patients developed increased postoperative uveitis. One developed clinically significant macular oedema.
Conclusions The method described has definite practical advantages over PRP attempted in the immediate post-operative period, when many factors can prevent its application or reduce its effectiveness, and when neovascularisation may be progressing rapidly. In addition, adjunctive per-operative indirect laser PRP appears to improve the outcome of cataract surgery in eyes with active proliferative diabetic eye disease.
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West, J., Dowler, J., Hamilton, A. et al. Panretinal photocoagulation during cataract extraction in eyes with active proliferative diabetic eye disease. Eye 13, 170–173 (1999). https://doi.org/10.1038/eye.1999.45
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DOI: https://doi.org/10.1038/eye.1999.45
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Treatment of diabetic eye disease
Eye (1999)