CLINICAL STUDY OF RETINAL CHANGES OF DIABETIC PATIENTS UNDERGONE CATARACT SURGERY WITH PRE-EXISTING DIABETIC RETINOPATHY AND WITHOUT PRE-EXISTING DIABETIC RETINOPATHY IN A TERTIARY CENTER OF WEST BENGAL.

Abstract

Aim: The aim of this study was evaluation and compare the visual outcomes after cataract surgery in diabetic and non-diabetic patients: patients with and without diabetic retinopathy; assessment of post-operative complications after cataract surgery in diabetics compared to nondiabetics; and analysis of increment in central foveal thickness using optical coherence tomography, after cataract surgery. Methods: This Institutional based Observational study was done at Outpatient department, Indoor Department and Special retina Clinic in R. G. Kar Medical College and Hospital, Kolkata over the Period of January 2019 to June 2020. This study included 125 diabetic patients with pre - existing diabetic retinopathy and 125 no pre-existing diabetic retinopathy controls. After complete ophthalmological examination, all subject undergone for cataract surgery. Post-operative visual acuity, intra or post-operative complication and change in subfoveal macular thickness recorded in a predesigned chart and subsequently analysed. Results: A total of 250 eyes were included in this study of them 125 were with diabetic retinopathy and 125 were without diabetic retinopathy respectively. There were 89 eyes with mild NPDR, 32 with moderate NPDR and 4 with severe NPDR respectively. Male female ratio was 1.7: 1. Most of the patients were at 50-70 years age group. Patients with uncontrolled baseline glycosylated haemoglobin level (HbA1c<7) was found to be a major confounding factor as far as post-op visual recovery was concerned. Common post-operative complications after cataract surgery were transient corneal oedema, Descemet's fold, hyphaema, iritis, misshapen pupil and pigment deposit on IOL respectively. Descemet's membrane folds being the most frequent complication, however the difference was not statistically signicant. In our study, increase in central foveal thickness was seen in both the groups, 6 months after cataract surgery