The visual status of diabetic patients after renal transplantation

To determine the effect of renal transplantation on visual status, we studied 134 eyes of 67 diabetic patients prospectively for one to seven years, with a mean of three years, after surgery. The best-corrected visual acuity and retinopathy status were determined at the time of surgery and annually thereafter. Useful visual acuity (greater than or equal to 6/15 [20/5o]) was present in 49% (66) of the eyes at the time of the baseline examination and in 51% (69) at the final determination. Of the 134 eyes 40% (54) were legally blind (less than or equal to 6/60 [20/200]) before surgery. Sixty-eight percent (91) of the eyes showed no significant visual change during the period of follow-up, 15% (20) showed significant improvement, and 17% (23) deteriorated significantly after surgery. With regard to the retinovitreous findings, 13% (12) of the eyes had non-proliferative retinopathy, 20% (26 had active proliferative retinopathy, and 67% (90) had inactive or involutional retinopathy. The results of this study showed stable or improved visual function in 83% (111) of the eyes after renal transplantation. Transplantation before dialysis becomes necessary may ben an important consideration in an attempt to reduce the high incidence of visual impairment in diabetic patients with renal failure.