Progression of nonproliferative diabetic retinopathy following cataract extraction

Eight patients experienced progression of nonproliferative diabetic retinopathy following cataract extraction. Six patients underwent an uncomplicated extracapsular cataract extraction with placement of a posterior chamber intraocular lens, and in two patients, surgery was complicated by vitreous loss. In each case the retinopathy progressed to a severe exudative form of diabetic macular edema, characterized by diffuse retinal thickening and fluorescein leakage with increased dot and blot hemorrhages and lipid deposition. In all patients, clinically significant macular edema developed in the eye that had been operated on, and six patients received laser photocoagulation for this condition. Final visual acuity was worse than preoperative visual acuity in six of eight patients, and it was unchanged in two of six patients. No patient achieved a visual acuity better than 20/50. The fellow eyes, which were not operated on, remained stable during the follow-up period.