Experience with intraocular lens implants in patients with diabetes

We conducted a retrospective study of 29 diabetic patients (16 women and 13 men, all at least 60 years old) who underwent intraocular lens implantation (23 anterior chamber lenses, three iris-supported lenses, and three posterior chamber lenses) in conjunction with cataract extraction. The cataracts were either unilateral or, if bilateral, there was a four-line difference in visual acuity between fellow eyes. We included only patients with no diabetic retinopathy or only minimal background angiopathy. There were no surgical complications in any of the eyes. Transient postoperative increases in intraocular pressure were easily controlled with medication. Final corrected visual acuities ranged from 20/20 to 20/200; 20 of the 29 patients achieved final visual acuities of 20/40 or better. In two patients, background retinopathy became active, leading to significant macular edema four months and one year later. In both cases, the macular edema decreased visual acuity from 20/30 to 20/200, although the visual acuity in one eye returned to 20/40 after laser photocoagulation. One patient had a cerebral vascular accident resulting in cortical blindness five months postoperatively and another developed rubeosis iridis and neovascular glaucoma 15 months postoperatively.