How Diabetes Affects Cataract Surgery

Dr. Gary Foster- Fort Collins & Loveland, CO

considerations for diabetics during cataract surgery

Diabetic Cataract
Considerations for Diabetes and Cataract Surgery

The good news is that diabetic cataract surgery is just like standard cataract removal with a couple of special steps in the preparation, timing, and post-operative protections.

Diabetic Cataract

Diabetic cataracts tend to come on at a slightly younger age.  Having said that, it is not harder to remove diabetic cataracts.

Preoperative Preparation for Diabetes and Cataract

Some patients with diabetic cataracts develop swelling in the center of their retina called Diabetic Macular Edema. If this is detected in your preoperative visit, then your eye surgeon will likely postpone your surgery for a while so you will have time to visit with your retinal specialist to have this treated and under control before the surgery.

If you have any active infections in your body, then it is wise to alert your eye doctor and to have those treated and well controlled prior to your diabetic cataract surgery.

Timing of Diabetic Cataract Surgery

When your retinologist feels you are stable for surgery, then you can proceed.  On the actual day of the procedure there are some special considerations with timing because of your blood sugars.  Most surgeons ask you to fast for some period of time prior to the surgery.  This usually requires some adjustment in the amount of insulin you use so your blood sugars don’t bottom out.  Please discuss this with your eye surgeon and your primary care doctor ahead of time.

We try to schedule those with diabetes the first few cases of surgery so we can help you return to a normal eating schedule as quickly as possible.  We check your blood sugar soon after arriving at the surgical center and can make adjustments in your sugar level if necessary through the IV we routinely place for cataract surgery.

Post Operative Protections for Diabetic Cataract

I ask my friends with diabetic cataracts to start taking anti-inflammatory drops a week prior to their cataract surgery and then to continue them for two months after surgery.  This is to decrease the chance of inflammation and swelling from the surgery reaching the back of your eye to cause Cystoid Macular Edema (CME).

In addition, if there is any question, I have you revisit your retinal specialist about a month after diabetic cataract surgery to double check the macula.  They have a number of treatments available to help if swelling does develop, but we prefer to prevent it in the first place.

It is important to consider both your cataract and your diabetes as we plan for your cataract removal. We want to make your diabetic cataract removal as successful and safe as possible so you can have great vision. Ensuring the proper planning and protection of your vision is well worth the time you spend to put everything in your favor for your cataracts and diabetes.

If I can answer any further questions about diabetic cataract, please send me a note or schedule a time to meet with me at my office.

Comments

  1. I have cataract surgery in 8 hours…I am type 1 diabetic…I just had a low blood sugar and ate a piece of candy bar. What are my consequences?

    • Wes:
      The consequences of low blood sugar can be serious so it is important to find a way to elevate the sugar. The consequence of elevating the sugar with solid food like a candy bar could be the need to delay the surgery until later in the day to make sure there is nothing in your stomach that you could aspirate into your lungs if you became to sleepy from anesthesia during surgery or proceeding on time with surgery without any anesthesia. This will be a decision made by our surgeon and the anesthetist.
      God Bless,
      Gary Foster

  2. Julie Anderson says:

    I found this article very informative. Thank you. My surgery is sceduled for the end of the month at the University of Colorado Lions Eye Institute. No mention has been made regarding swelling but I am interested in the anti-inflammatory drops. Is a prescription only item?

    • Thanks Julie:
      The NSAID and the steroidal anti-inflammatory drops are all require a prescription.
      God speed with the surgery.
      Gary Foster