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

Department of Ophthalmology, University of Warmia and Mazury, 10-082 Olsztyn, Poland
Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 60-554 Poznan, Poland
Hygeia Clinic, 80-286 Gdańsk, Poland
Department of Ophthalmology, University Hospital Arnau de Vilanova, 25198 Lleida, Spain
Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain
Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
Helsinki Retina Research Group, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
Department of Ophthalmology, Kymenlaakso Central Hospital, 48210 Kotka, Finland
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(5), 716;
Received: 26 March 2019 / Revised: 8 May 2019 / Accepted: 15 May 2019 / Published: 20 May 2019
(This article belongs to the Section Ophthalmology)
PDF [272 KB, uploaded 20 May 2019]


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. View Full-Text
Keywords: cataract surgery; diabetic macular edema; diabetes mellitus; diabetic retinopathy; phacoemulsification cataract surgery; diabetic macular edema; diabetes mellitus; diabetic retinopathy; phacoemulsification
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Grzybowski, A.; Kanclerz, P.; Huerva, V.; Ascaso, F.J.; Tuuminen, R. Diabetes and Phacoemulsification Cataract Surgery: Difficulties, Risks and Potential Complications. J. Clin. Med. 2019, 8, 716.

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