Association between the progression of diabetic retinopathy and cataract surgery in patients with diabetes

Diabetic retinopathy is a leading cause of visual impairment in individuals with diabetes, and its progression after cataract surgery remain a concern. This study aimed to evaluate the association between cataract surgery and diabetic retinopathy progression in the Thai population. We conducted a retrospective analysis of 200 eyes from 100 patients with diabetes who underwent cataract surgery in one eye, using the non-operated fellow eye as a control to minimize confounding factors. Outcomes were assessed 12 months postoperatively. Potential risk factors were explored using univariate logistic regression analysis. The results revealed that diabetic retinopathy progression occurred more frequently in the operated eyes than in non-operated eyes (21% vs. 13%, P = 0.004). However, the progression of macular edema was not significant between groups (10% vs 9%, P = 0.740). Higher HbA1c levels, pre-existing diabetic retinopathy and insulin treatment were identified as significant risk factors for retinopathy progression (P = 0.002, 0.007, and 0.016 respectively). These findings suggest that cataract surgery is associated with diabetic retinopathy progression, particularly in patients with poor glycemic control or pre-existing diabetic retinopathy. Careful preoperative evaluation and close postoperative monitoring are essential to optimize visual outcomes and minimize complications in patients with diabetes undergoing cataract surgery.