Clinical outcomes of phacoemulsification cataract surgery in diabetes patients: visual function (VF-14), visual acuity and patient satisfaction.

PURPOSE: To evaluate the visual outcomes (visual acuity [VA] and visual function) after phacoemulsification cataract surgery in patients with diabetic retinopathy (DR), and assess patient satisfaction with final surgical outcome.

METHODS: This prospective study comprised 74 eyes of 74 patients with different stages of DR. One surgeon (AW) performed all cataract surgery in a standardized fashion. Patients were assessed using the VF-14 (Visual Function-14) questionnaire. The following groups of patients were compared: those with no apparent retinopathy; those with mild non-proliferative DR (NPDR); those with severe NPDR, and those with proliferative DR (PDR). Visual acuity and visual function questionnaire (VF-14) responses were recorded preoperatively and 3 months postoperatively, during which the non-operated fellow eye showed no progression in retinopathy.

RESULTS: Improvements in visual outcomes were significantly higher in groups 1 and 2 compared to groups 3 and 4 (Tukey-Kramer, p < 0.001). Comparisons between groups 1, 2 and 3, 4 showed significant differences in improvements in VA (Tukey-Kramer, p < 0.01), yet no statistically significant differences in functional (VF-14) improvements emerged between these groups.

CONCLUSIONS: Patients with more advanced levels of DR showed no functional improvements despite improvements in VA. This emphasizes the relevance of patient education prior to surgery. In particular, it should be explained to patients with more advanced DR that, although surgery may be required, their functional improvement may be limited.