Outcomes of Cataract Surgery in Diabetes Mellitus: A Multicenter Database Study

center dot PURPOSE: To compare the visual outcome and the rate of intraoperative complications in eyes of diabetic and nondiabetic patients undergoing phacoemulsification over 15 years. center dot DESIGN: Retrospective clinical cohort study. center dot METHODS: Data of 179,159 eyes that underwent phacoemulsification at 8 centers were classified based on the presence or absence of diabetes mellitus. Visual acuity (VA) was defined as the best value of uncorrected or corrected distance measure available. For the VA anal-ysis, eyes with co-pathologies or combined surgical pro-cedures were further excluded, leaving a subset of 90,729 eyes. Main outcome measures were logarithm of the minimum angle of resolution (logMAR) VA at 4-12 weeks postoperatively, and rate of intraoperative complications. center dot RESULTS: Cataract surgery in eyes of diabetic pa-tients was associated with an improvement in mean VA of 0.48 logMAR (5 Snellen lines). Mean postoper-ative VA was slightly worse in diabetic compared to nondiabetic group (logMAR 0.23 vs 0.13; Snellen 20/30 vs 20/25; P < .0001) and the proportions of eyes achieving a visual gain of & Dagger;3 Snellen lines (& Dagger;0.3 logMAR) was lower in the diabetic group (56.6% vs 63.5%; P < .0001). There was a linear relationship between diabetic retinopathy severity and worse post-operative visual acuity (b coefficient 0.098 to 0.288; P < .0001). We observed higher rates of posterior capsule rupture (2.3% vs 1.6%; P < .001) and drop-ped nuclear fragments (0.3% vs 0.2%; P < .001) in the diabetic group. center dot CONCLUSIONS: Postoperative VA negatively corre-lated with diabetes and diabetic retinopathy severity. Eyes of diabetic subjects had higher risks of posterior capsule rupture. (Am J Ophthalmol 2021;225: 47-56. Published by Elsevier Inc.)