Preparing for Cataract Surgery When You’re A Diabetic

If your natural lens in your eye becomes cloudy, as it does with cataracts, your vision will suffer. Cataracts are more common in diabetics. Moreover, the process leading up to, during, and after cataract surgery may, in diabetics, include additional measures.

In this post, we'll discuss why diabetics experience a higher risk for developing cataracts, as well as how to get ready for, undergo, and recover from cataract surgery.

The Role of Diabetes in the Prevalence of Cataracts

Age is a major risk factor for cataract formation. Over half of U.S. individuals will have undergone cataract surgery by the time they are 80.

Cataract surgery is the removal and replacement of a patient's native lens with an artificial lens. Cataracts, themselves, represent a buildup of protein and water over time - deposits that keep light from passing directly into the lens. When this happens, the patient’s vision is usually blurred.

Your chance of acquiring cataracts is increased if you have either type one or type two diabetes. That is because elevated blood sugar levels are associated with changes in the lens that hasten the onset of cataracts.

Factors that Influence Cataract Development in Diabetics

Several factors may influence cataract development, including:

• The length of time you’ve had diabetes
• How frequently you obtain high or low of readings - numbers that are uncomfortable
• Fluid buildups in the central part of the retina (macula), which is the light-sensitive tissue in the back of the eye

Other Reasons for Cataract Development

Besides the passage of time, cataracts may develop from:

• Steroid use
• UV radiation
• Smoking

What the Research Reveals

One 2018 study showed that people who had diabetes had a greater cataract risk. Over 56,000 people took part in the research. Diabetics who were 40 years and older contributed to the findings.

During the study, researchers learned that cataracts developed at a younger age in diabetics than it did in non-diabetics. They also occurred more frequently in people who had diabetes for a longer time.

Researchers have determined that diabetics are more likely to have complications after surgery, such as delayed wound healing or infections. However, this does not mean you should not undergo the surgery. Your eyesight will improve and you’ll lead a higher quality of life by opting for this normally safe outpatient procedure.

Planning for Cataract Surgery

Your doctor will monitor cataract development in one or both eyes. You may also need new eyeglasses if you’re diabetic. When the cataract becomes more severe, or interferes with your vision, an ophthalmologist may advise that you have it removed sooner rather than later.

You will get instructions on how to get ready for surgery from the ophthalmologist. These guidelines are similar to the ones given to non-diabetics.

Your ophthalmologist may spend some time assessing the correlation between your visual complaints and the degree to which your cataracts have progressed.

This may happen if you have a retinal issue as well. This is because diabetes often contributes to diabetic retinopathy, which may also lead to vision loss.

Diabetic retinopathy is an eye disease caused by the high blood pressure related to diabetes. It is marked by floaters (dark strings or spots floating in your field of vision), blurriness, fluctuating vision, and empty and dark areas when you see.

If you wear contact lenses, your surgeon will ask that you refrain from doing so. Infection-fighting and eye-healing drops may be administered in the days prior to surgery.

Check with your eye doctor to see if you may take your diabetes medicine on the day of the procedure. The morning before the surgery, you may be advised to hold off taking medications.

What Happens During Surgery?

In most cases, you’ll probably be awake through most of the surgery. In addition to a local anesthetic, you’ll be given a sedative, in some cases, to help you relax. A laser is normally used to create a circular opening so the surgeon can access and remove the cataract.

Types of Cataract Surgery

Phacoemulsification is an example of a common surgical process that uses ultrasound to emulsify the nucleus of a cataract, a vacuum to capture nuclear material, and aspiration for viscoelastic and cortex removal. The machine is composed of an  irrigation and aspiration system and features a foot pedal and hand piece.

In simpler terms, a phacoemulsification laser or similar high-precision laser is used to break up a cataract so it can be suctioned and removed. After removal, the surgeon inserts an intraocular lens  (IOL) into the eye to replace the eye’s natural lens. The incised eye tissue at the site heals without the need for sutures.

Medicines, such as triamcinolone or anti-vascular endothelial growth factors, may be injected into the eye for support and healing.

What to Expect After Cataract Surgery

Your ophthalmologist may recommend steroid and nonsteroidal anti-inflammatory eye drops after cataract surgery to reduce inflammation.

These aids are also useful in the treatment and prevention of macular edema. The surgical staff will provide you with instructions on when to use these drops. In some instances, you may not need the drops if a healing medicine is administered directly into the eye.

Cataract Surgery Complications

Complications from cataract surgery may include:

• Decreased sensitivity of the cornea (the dome-shaped front part of the eye).
• Endophthalmitis, an extremely rare but potentially blinding eye infection, which affects diabetics more frequently.
• Diabetic macular swelling, which can be resolved, if required.
• Opacification of the capsule containing the IOL at the posterior aspect (this may affect visual clarity and lead to problems with glare). A laser may be used to resolve the issue.
• The onset of retinopathy

Recovery after Surgery

Usually, you will note an improvement in your eyesight three days after surgery. However, a complete recovery usually takes several weeks. Your eye doctor will arrange follow-up visits to check your visual progress after the procedure.

When to Contact Your Doctor

If you have any of the following symptoms after cataract surgery, you need to see your ophthalmologist immediately:

• Red eyes
• Vision decline
• Rapid or complete blindness
• Alterations in your field of vision

Conclusion

Diabetics  have an increased risk for developing cataracts both during the aging process and in frequency. Fortunately, the use of specialized surgical procedures and medicines can reduce the likelihood of complications.

If you have diabetes and need to undergo cataract surgery, you run the risk of complications, such as the worsening of diabetic retinopathy or posterior capsular opacification. Therefore, seeing your eye doctor regularly is imperative.

Contact Cohen & Laser Vision Center Today

Getting an eye exam can help you maintain your vision and get the help you need with any visual disturbances. Contact Cohen & Laser Vision Center now and schedule an appointment today.