Long‐term results of cataract surgery in type 2 diabetics, a 20‐year prospective longitudinal study

Abstract

AbstractPurposeTo investigate the 20‐year outcome, in best‐corrected visual acuity (BCVA), and subjective visual function (VF‐questionnaire, VF‐14) after cataract surgery in type 2 diabetics, compared with non‐diabetics.Methods109 type 2 diabetics and 698 non‐diabetics, who had cataract surgery during 1 year at one institution, were included in this prospective, longitudinal, population‐based cohort study. BCVA and VF‐14 responses were recorded pre‐ and postoperatively, and every 5 years up to 20 years after surgery. Retinopathy was graded before surgery.ResultsThere was no significant difference between diabetics and non‐diabetics, in change in BCVA from 10 years or more after surgery, p = 0.45, p = 0.44 and p = 0.83, at 10, 15 and 20 years, respectively, as well as in self‐perceived visual function (VF‐14) at any time after surgery, p = 0.72, p = 0.20 and p = 0.78, 10–20 years, respectively.At any follow‐up, there was no significant difference in BCVA in relation to retinopathy level before surgery, p = 0.1 at 20 years. There was a trend from 10 years after surgery and onward that patients with no retinopathy at baseline lost fewer letters during the 20 years than diabetics with retinopathy. Patients with known type 2 diabetes at surgery had a significantly lower survival compared with the non‐diabetics at each follow‐up, p = 0.003.ConclusionIn surviving diabetics, BCVA and subjective visual function were retained in most cases up to 20 years after cataract surgery. Cataract extraction is effective in causing a sustainable improvement in visual function also in type 2 diabetics. Knowledge of these long‐term outcomes is essential when counselling diabetics for cataract surgery.