Effect of Two Different Surgical Methods on Age-Related Cataracts with Long-Standing Type 2 Diabetes Mellitus: A...

This retrospective case-control study evaluated anterior segment recovery after small-incision cataract surgery (SICS) and phacoemulsification (PE) in patients with age-related cataracts and long-standing (≥10 years) type 2 diabetes mellitus (T2DM). A total of 165 patients (165 eyes) were included, with 83 eyes undergoing SICS and 82 eyes undergoing PE. Glycated hemoglobin (HbA1c), diabetic retinopathy status, renal function, diabetic peripheral neuropathy status, preoperative ocular surface disease severity, and quantitative lens density were assessed. Intraoperative parameters, including operative duration, nuclear delivery difficulty, cumulative dissipated energy (CDE), ultrasound settings, balanced salt solution (BSS) irrigation volume, and surgically induced astigmatism (SIA), were recorded. Best-corrected visual acuity (BCVA), tear film break-up time (TBUT), Schirmer I test (SIT), corneal endothelial cell density (CECD), and central corneal thickness (CCT) were evaluated preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively. In both groups, BCVA improved significantly and stabilized by 1 month after surgery. TBUT and SIT decreased postoperatively and returned to baseline levels by 6 months. CECD decreased significantly and stabilized by 3 months, whereas CCT increased transiently and returned to baseline within 1 month. No statistically significant between-group differences were observed in BCVA, TBUT, SIT, or CCT; CECD was transiently higher in the PE group at 1 week and 1 month postoperatively. These findings show that SICS and PE were associated with similar visual recovery, ocular surface outcomes, and corneal endothelial changes during the 6-month follow-up period in patients with long-standing T2DM and age-related cataracts.