What your patient might ask you…

Am I more likely to get diabetic macular edema after cataract surgery?

study out of the UK says yes, the risk increases depending on the level of retinopathy prior to surgery.
Let’s discuss.

Cataract surgery is known to lead to increased levels of inflammatory mediators (prostaglandins, VEGF, inflammatory cytokines etc). This study reviewed medical records from over 4800 diabetic patients. Some of the diabetic patients had retinopathy, some did not but none had previous treatment for diabetic macular edema.

They found the “rate of developing treatment-requiring diabetic macular edema increases sharply in the year after cataract surgery for all grades of retinopathy, peaking in the 3–6 month postoperative period”. Patients with moderate and severe NPDR are at particularly high risk.
Take home: Patients with diabetic retinopathy should be monitored closely in the postoperative period to evaluate for DME.