الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This study was carried out to detect any progression of diabetic retinopathy following phacoemulsification in cataractous diabetic patients and to determine whether complicated cases of phacoemulsification with opening of posterior capsule during surgery affects the progression of diabetic retinopathy . Forty cataractous diabetic patients were included in this study and were divided into two groups: - Group A : Including twenty patients selected among uncomplicated phacoemulsification surgeries with PMMA or acrylic PCIOL implantation - Group B : Including twenty patients selected among phacoemulsification surgeries with accidental opening of posterior capsule during surgery and subsequent removal of anterior vitreous face with or without IOL implantation in the same session. There was no statistically significant difference between both groups with respect to age, sex, type of diabetes, duration of diabetes, preoperative visual acuity, grade of DR, macular oedema or mean foveal thickness.Cases received follow up examination including BCVA, fundus examination, fluorescein angiography and OCT, up to 6 months after surgery. Data were then collected and compared between the two groups. By the end of the study visual acuity has improved by 2 or more lines in 90% of group A patients and in 85% of group B patients. As regard foveal thickness it was observed that, the preoperative mean CMT was better in group B than group A with statistically insignificant difference p-value=0.158. After six months follow up, the mean CMT in group A was better than group B with statistically significant difference p-value=0.032. The preoperative macular oedema showed statistically insignificant difference between studied groups p value=0.213, but postoperatively the change in fluorescein angiography showed more progression in group B in relation to group A. This progression was detected in 30% of cases in group B compared to only 10% of cases of group A by the end of follow up visits with statistically significant difference p-value =0.025. Diabetic retinopathy showed progression rate of 10% of cases of group A compared to20% of those of group B. The difference between groups as regard DRprogression was highly significant (p-value=0.001). This study stated that, uncomplicated phacoemulsification does not cause acceleration of diabetic retinopathy postoperatively and any progression that is observed probably represents the natural history of the disease. Although macular oedema is common after cataract surgery, it may follow a benign course and in many patients the development of clinically significant macular oedema postoperatively probably represents natural progression rather than being a direct effect of surgery. The statistically significant higher progression rate in diabetic retinopathy observed in complicated cases (group B) may be explained by interruption of the blood retinal barrier following posterior capsular tear. An explanation needed to be proved by further studies.