Eyeworld

EW RESIDENTS 32 November 2011 by Meenakashi Gupta, M.D., Jessica Rankin, M.D., Athanasios Papakostas, M.D., Justin Kanoff, M.D., Laurence Rand, M.D., and John Loewenstein, M.D. Review of "Phacoemulsification cataract surgery in a large cohort of diabetes patients: I n their article published this month, "Phacoemulsification cataract surgery in a large co- hort of diabetes patients" Ostri et al. evaluated cataract surgery outcomes among diabetic patients using data from the Danish National Patient Registry. The authors con- ducted a retrospective cohort study to assess changes in visual acuity and degree of diabetic retinopathy in 285 type 1 and 2 diabetic patients who underwent cataract surgery from 1999 to 2008. Best corrected vi- sual acuity (BCVA) increased signifi- cantly after cataract surgery regardless of the degree of pre-op non-proliferative diabetic retinopa- thy. Progression of diabetic retinopa- thy was noted in 35% of patients after cataract surgery. Post-op BCVA was positively correlated with pre-op BCVA and negatively correlated with age and the degree of pre-op diabetic retinopathy. Given the large and growing number of diabetic patients world- wide, we commend the authors' ef- forts to help clinicians decide whether cataract surgery is likely to benefit these patients. This study supports the conclusion of prior studies that a significant improve- ment in visual acuity can be ex- pected with phacoemulsification cataract surgery among diabetic pa- tients with all levels of non-prolifer- ative diabetic retinopathy. Although other studies have tried to address this question, many have been lim- ited by small sample size. By analyz- ing data from the Danish National Patient Registry, the authors were able to study cataract surgery out- comes of a large population from multiple centers over an 8-year pe- riod, increasing the generalizability of their results. Standardization was improved by evaluating diabetic retinopathy and macular edema of all patients pre- and post-op at a sin- gle diabetes center. There are, however, limitations in both the study design and the conclusions reached from the data. Although the authors drew their data from a prospectively collected database, the study was a retrospec- tive observational analysis. As the authors acknowledge, documenta- tion of some important clinical in- formation was not available, including pre-op degree of cataract, THE BEST OF BOTH WORLDS Only the GALILEI G2 merges the Placido and Dual Scheimpflug Technologies into a single measurement. The combined data provide highly accurate values for surgical evaluation and planning, leading to unrivalled clinical results Move to the next level of accuracy in Anterior Segment Tomography Call 1- 866-708-4490 or visit www.ziemergroup.com for further information about how GALILEI G2 can improve outcomes for your patients for surgical eval into a single measurement. The combined data provide highly accurate values Only the GALILEI G uation and planning, leading to unrivalled clinical results ement. The combined data provide highly accurate values 2 merges the Placido and Dual S T THE BES unrivalled clinical results de highly accurate values echnologies Scheimpflug T H WORLDS T OF BO T Ridge Street, Alton, IL 62002, USA 1 32 Ziemer USA, Inc. about how GALILEI G2 can improve outcomes for your patients 866- - 1 Call Ridge Street, Alton, IL 62002, USA about how GALILEI G2 can improve outcomes for your patients .ziemergroup.com for further information 708-4490 or visit www 866- about how GALILEI G2 can improve outcomes for your patients .ziemergroup.com for further information This month I asked the residents of the Massachusetts Eye and Ear Infirmary to review this interesting article on phaco in diabetic patients from the November issue of the Journal of Cataract and Refractive Surgery (see abstract on page 33.) — David F. Chang, M.D., chief medical editor EyeWorld journal club John Lowenstein, M.D. Residency program director, Massachusetts Eye and Ear Infirmary

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