Do diabetics have an increased risk of developing macular edema after cataract surgery?

According to a new study, yes.
The study used electronic health record data from over 4800 eyes undergoing cataract surgery. All patients were diabetic with various levels of retinopathy but none had been treated for diabetic macular edema for two years prior to their cataract surgery.

What did they find?
“The risk of developing treatment-requiring diabetic macular edema was significantly associated with the pre-operative grade of retinopathy. Severe nonproliferative diabetic retinopathy had the highest risk.”

What is considered “treatment requiring”?
A central macular thickness of >400 microns.

When is the highest risk period?
Between 3 to 9 months after cataract surgery.

How do they know it was diabetic edema and not pseudophakic edema?
The authors state because for pseudophakic edema, standard practice is to treat with steroids (topical steroids and/or non-steroidal drops) as first line treatment and this only accounted for a small percentage of the cases in this study.

The take home:  The rate of developing treatment-requiring DME increases sharply in the year after cataract surgery for all grades of retinopathy, peaking in the 3–6 months postoperative period. Patients with moderate and severe NPDR are at particularly high risk.

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