Dr. Chikako Suto from Tokyo Women's Medical University and colleagues determined the effect of perioperative glycemic control on progression of diabetic retinopathy and maculopathy in 87 type 2 diabetics who had phacoemulsification cataract surgery performed on one eye by a single surgeon.

Twenty-seven of the patients had poor glycemic control before surgery and underwent rapid preoperative glycemic correction; 30 had poor preoperative glycemic control that was not corrected prior to surgery; and 30 patients had good preoperative glycemic control.

The investigators compared the grade of diabetic retinopathy and maculopathy in the operated eye and the non-operated eye before surgery and for 12 months after surgery.

Overall, there were no significant between-group differences in the rate of progression of retinopathy one year after surgery. Postoperative progression of retinopathy was seen in 30% of the rapid glycemic control group, 17% of the poor glycemic control group, and 13% of the good control group.

However, according to Dr. Suto and colleagues, the rate of progression of diabetic maculopathy was significantly higher (33%) in patients who underwent rapid glycemic correction prior to surgery compared with the other two groups (p = 0.02).

Patients in the rapid control group with moderate to severe nonproliferative diabetic retinopathy before surgery had significantly higher rates of progression of diabetic retinopathy (p = 0.002) and maculopathy (p= 0.008) after surgery.