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Cataract Surgery in Diabetic
Patients:
The vast majority of lens
opacities in adult diabetics
are nuclear sclerotic in
type, but they do progress
more rapidly and become
symptomatic at a younger age
than in nondiabetics.
The preoperative cataract
evaluation of a diabetic
should include;
A potential acuity meter
measurement,
Retinal assessment,
When deemed necessary, a
fluorescein angiogram.
Pre-existing active
retinopathy with macular
edema portends poor visual
results.
Intraoperative difficulties
include:
Increased endothelial and
iris pigment epithelial
fragility.
Increased vascular leakage
and inflammation, fibrin
deposition.
Increased vulnerability to
operating microscope light
injury.
Postoperative problems may
include:
Increased risk of synechia
formation and pupillary
block,
Cystoid macular edema,
Rapid development of
capsular thickening, and
increased risk of vitreous
hemorrhage.
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