Diabetic-retinopathy progression following phacoemulsification: A metaanalysis

ABSTRACT

Purpose: To determine the effect of phacoemulsification on the progression of diabetic retinopathy. Methods: We conducted an electronic search of the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) on The Cochrane Library (Issue 1, 2005), MEDLINE, and the reference lists of identified trials evaluating the effects of phacoemulsification on the progression of diabetic retinopathy. There were no language or date restrictions in the electronic search. Two reviewers independently assessed the articles for inclusion. Odds ratio at 95 percent confidence interval was determined using Review Manager 4.2.2 (The Cochrane Collaboration, Oxford, United Kingdom). Results: No randomized controlled trials were found. Five non randomized, prospective, case-controlled trials involving a total of 804 eyes were included in this review. All 5 trials studied the effects of phacoemulsification on the progression of diabetic retinopathy using the fellow nonoperated eye as control. Pooled analysis showed weak evidence to support the progression of diabetic retinopathy (RR=1.36 95 percent; CI 0.95-1.96) in eyes that underwent phacoemulsification compared with eyes that did not. Conclusion: The available literature consists mainly of retrospective case reviews and case-controlled trials that are difficult to compare and analyze due to variations in the definition of progression and retinopathy assessment and surgical technique. However, the 5 studies reviewed show that uncomplicated phacoemulsification had minimal or no effect on the progression of diabetic retinopathy. Further randomized, controlled trials are needed to confirm this finding.