Diyabetes Mellitusun Diyabetik Retinopati Dışı Göz Etkileri
Özet
Diyabetin diyabetik retinopati dışındaki göz etkilerini ele alan bu bilimsel çalışma, kronik hiperglisemiye bağlı gelişen oküler patolojileri ve cerrahi yönetimdeki farklılıkları kapsamlı bir şekilde incelemektedir. Diyabet, kornea düzeyinde subbazal sinir yoğunluğunu azaltarak nöropatiye, epitelyal bariyer fonksiyonlarını bozarak da epitelyopatiye ve ciddi kuru göz hastalığına yol açmaktadır. Ayrıca, stromada ileri glikolizasyon son ürünlerinin (AGEs) birikmesi kornea kalınlığını ve sertliğini artırmaktadır. Katarakt cerrahisinde ise diyabetli hastalar yetersiz pupiller dilatasyon, artmış endoftalmi riski ve psödofakik kistoid maküla ödemi (PKMÖ) gibi ciddi komplikasyonlarla karşılaşmaktadır. Çalışma, proliferatif retinopati olmasa dahi anjiyogenetik faktörlerin etkisiyle neovasküler glokom (NVG) gelişebileceğini ve açık açılı glokom riskinin arttığını göstermektedir. Optik sinir boyutunda arteritik olmayan anterior iskemik optik nöropati (NAİON), diyabetik papillopati ve oküler kraniyal sinir felçleri tetiklenirken; vasküler yapıda ise santral retinal ven ve arter tıkanıklığı riski yaklaşık iki katına çıkmaktadır. Sonuç olarak, diyabetli bireylerde yapılacak tüm oküler ve refraktif cerrahi girişimler öncesinde sıkı glisemik kontrol, perioperatif proflaksi ve multidisipliner bir takip protokolü hayati önem taşımaktadır.
This scientific review examines the ocular pathologies of diabetes mellitus beyond diabetic retinopathy, emphasizing the challenges in medical and surgical management driven by chronic hyperglycemia. In the cornea, diabetes causes neuropathy by reducing subbasal nerve density, and leads to epitheliopathy and severe dry eye disease due to impaired epithelial barrier functions. Furthermore, advanced glycation end products (AGEs) accumulate within the stroma, increasing corneal thickness and stiffness. During cataract surgery, diabetic individuals face higher risks of complications, including poor pupillary dilatation, increased endophthalmitis, and pseudophakic cystoid macular edema (PCME). The study highlights that even without active proliferative retinopathy, angiogenic factors can trigger neovascular glaucoma (NVG) and elevate the risk of open-angle glaucoma. Regarding the optic nerve, conditions like non-arteritic anterior ischemic optic neuropathy (NAION), diabetic papillopathy, and ocular cranial nerve palsies are prominent, while vascular risks such as central retinal vein and retinal artery occlusions nearly double. Consequently, strict glycemic control, targeted perioperative prophylaxis, and rigorous multi-disciplinary follow-up are critical before performing any ocular or refractive surgeries in diabetic patients.
Referanslar
Nowotny K, Jung T, Höhn A, et al. Advanced glycation end products and oxidative stress in type 2 diabetes mellitus. Biomolecules. 2015;5(1):194-222. doi:10.3390/biom5010194
Yagihashi S, Mizukami H, Sugimoto K. Mechanism of diabetic neuropathy: Where are we now and where to go? Journal of diabetes investigation. 2011;2(1):18-32. doi:10.1111/j.2040-1124.2010.00070.x
Babizhayev MA, Strokov IA, Nosikov VV, et al. The Role of Oxidative Stress in Diabetic Neuropathy: Generation of Free Radical Species in the Glycation Reaction and Gene Polymorphisms Encoding Antioxidant Enzymes to Genetic Susceptibility to Diabetic Neuropathy in Population of Type I Diabetic Patients. Cell biochemistry and biophysics. 2015;71(3):1425-43. doi:10.1007/s12013-014-0365-y
Kim J, Kim CS, Sohn E, et al. Involvement of advanced glycation end products, oxidative stress and nuclear factor-kappaB in the development of diabetic keratopathy. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. 2011;249(4):529-36. doi:10.1007/s00417-010-1573-9
Stavniichuk R, Shevalye H, Hirooka H, et al. Interplay of sorbitol pathway of glucose metabolism, 12/15-lipoxygenase, and mitogen-activated protein kinases in the pathogenesis of diabetic peripheral neuropathy. Biochemical pharmacology. 2012;83(7):932-40. doi:10.1016/j.bcp.2012.01.015
Aubert CE, Michel PL, Gillery P, et al. Association of peripheral neuropathy with circulating advanced glycation end products, soluble receptor for advanced glycation end products and other risk factors in patients with type 2 diabetes. Diabetes/metabolism research and reviews. 2014;30(8):679-85. doi:10.1002/dmrr.2529
Geraldes P, King GL. Activation of protein kinase C isoforms and its impact on diabetic complications. Circulation research. 2010;106(8):1319-31. doi:10.1161/circresaha.110.217117
Tomlinson DR, Fernyhough P, Diemel LT. Role of neurotrophins in diabetic neuropathy and treatment with nerve growth factors. Diabetes. 1997;46 Suppl 2:S43-9. doi:10.2337/diab.46.2.s43
Zherebitskaya E, Akude E, Smith DR, et al. Development of selective axonopathy in adult sensory neurons isolated from diabetic rats: role of glucose-induced oxidative stress. Diabetes. 2009;58(6):1356-64. doi:10.2337/db09-0034
Ryle C, Donaghy M. Non-enzymatic glycation of peripheral nerve proteins in human diabetics. Journal of the neurological sciences. 1995;129(1):62-8. doi:10.1016/0022-510x(94)00251-i
Obrosova IG. Diabetes and the peripheral nerve. Biochimica et biophysica acta. 2009;1792(10):931-40. doi:10.1016/j.bbadis.2008.11.005
Greene DA, Sima AA, Stevens MJ, et al. Complications: neuropathy, pathogenetic considerations. Diabetes care. 1992;15(12):1902-25. doi:10.2337/diacare.15.12.1902
Ziegler D, Papanas N, Zhivov A, et al. Early detection of nerve fiber loss by corneal confocal microscopy and skin biopsy in recently diagnosed type 2 diabetes. Diabetes. 2014;63(7):2454-63. doi:10.2337/db13-1819
Messmer EM, Schmid-Tannwald C, Zapp D, et al. In vivo confocal microscopy of corneal small fiber damage in diabetes mellitus. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. 2010;248(9):1307-12. doi:10.1007/s00417-010-1396-8
Pritchard N, Edwards K, Vagenas D, et al. Corneal sensitivity is related to established measures of diabetic peripheral neuropathy. Clinical & experimental optometry. 2012;95(3):355-61. doi:10.1111/j.1444-0938.2012.00729.x
Pritchard N, Edwards K, Vagenas D, et al. Corneal sensitivity as an ophthalmic marker of diabetic neuropathy. Optometry and vision science : official publication of the American Academy of Optometry. 2010;87(12):1003-8. doi:10.1097/OPX.0b013e3181fd6188
Tavakoli M, Kallinikos P, Iqbal A, et al. Corneal confocal microscopy detects improvement in corneal nerve morphology with an improvement in risk factors for diabetic neuropathy. Diabetic medicine : a journal of the British Diabetic Association. 2011;28(10):1261-7. doi:10.1111/j.1464-5491.2011.03372.x
Yorek MS, Obrosov A, Shevalye H, et al. Effect of diet-induced obesity or type 1 or type 2 diabetes on corneal nerves and peripheral neuropathy in C57Bl/6J mice. Journal of the peripheral nervous system : JPNS. 2015;20(1):24-31. doi:10.1111/jns.12111
Misra SL, Craig JP, Patel DV, et al. In Vivo Confocal Microscopy of Corneal Nerves: An Ocular Biomarker for Peripheral and Cardiac Autonomic Neuropathy in Type 1 Diabetes Mellitus. Investigative ophthalmology & visual science. 2015;56(9):5060-5. doi:10.1167/iovs.15-16711
DeMill DL, Hussain M, Pop-Busui R, et al. Ocular surface disease in patients with diabetic peripheral neuropathy. The British journal of ophthalmology. 2016;100(7):924-928. doi:10.1136/bjophthalmol-2015-307369
Tavakoli M, Begum P, McLaughlin J, et al. Corneal confocal microscopy for the diagnosis of diabetic autonomic neuropathy. Muscle & nerve. 2015;52(3):363-70. doi:10.1002/mus.24553
Nitoda E, Kallinikos P, Pallikaris A, et al. Correlation of diabetic retinopathy and corneal neuropathy using confocal microscopy. Current eye research. 2012;37(10):898-906. doi:10.3109/02713683.2012.683507
Bitirgen G, Ozkagnici A, Malik RA, et al. Corneal nerve fibre damage precedes diabetic retinopathy in patients with type 2 diabetes mellitus. Diabetic medicine : a journal of the British Diabetic Association. 2014;31(4):431-8. doi:10.1111/dme.12324
Leong YY, Tong L. Barrier function in the ocular surface: from conventional paradigms to new opportunities. The ocular surface. 2015;13(2):103-9. doi:10.1016/j.jtos.2014.10.003
Cai D, Zhu M, Petroll WM, et al. The impact of type 1 diabetes mellitus on corneal epithelial nerve morphology and the corneal epithelium. The American journal of pathology. 2014;184(10):2662-70. doi:10.1016/j.ajpath.2014.06.016
Yin J, Huang J, Chen C, et al. Corneal complications in streptozocin-induced type I diabetic rats. Investigative ophthalmology & visual science. 2011;52(9):6589-96. doi:10.1167/iovs.11-7709
Kim EC, Kim DJ, Lee SS, et al. Ultrastructural changes of cornea after ethanol ingestion in Otsuka Long-Evans Tokushima fatty (OLETF) and Long-Evans Tokushima Otsuka (LETO) rats. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. 2010;248(10):1457-66. doi:10.1007/s00417-010-1432-8
Di G, Du X, Qi X, et al. Mesenchymal Stem Cells Promote Diabetic Corneal Epithelial Wound Healing Through TSG-6-Dependent Stem Cell Activation and Macrophage Switch. Investigative ophthalmology & visual science. 2017;58(10):4344–4354. doi:10.1167/iovs.17-21506
Nakamura M, Ofuji K, Chikama T, et al. Combined effects of substance P and insulin-like growth factor-1 on corneal epithelial wound closure of rabbit in vivo. Current eye research. 1997;16(3):275-8. doi:10.1076/ceyr.16.3.275.15409
Yamada M, Ogata M, Kawai M, et al. Substance P in human tears. Cornea. 2003;22(7 Suppl):S48-54. doi:10.1097/00003226-200310001-00007
Markoulli M, You J, Kim J, et al. Corneal Nerve Morphology and Tear Film Substance P in Diabetes. Optometry and vision science : official publication of the American Academy of Optometry. 2017;94(7):726-731. doi:10.1097/opx.0000000000001096
Yamada M, Ogata M, Kawai M, et al. Decreased substance P concentrations in tears from patients with corneal hypesthesia. American journal of ophthalmology. 2000;129(5):671-2. doi:10.1016/s0002-9394(00)00415-3
Rocha EM, Cunha DA, Carneiro EM, et al. Identification of insulin in the tear film and insulin receptor and IGF-1 receptor on the human ocular surface. Investigative ophthalmology & visual science. 2002;43(4):963-7.
Ding J, Liu Y, Sullivan DA. Effects of Insulin and High Glucose on Human Meibomian Gland Epithelial Cells. Investigative ophthalmology & visual science. 2015;56(13):7814-20. doi:10.1167/iovs.15-18049
Chen DK, Frizzi KE, Guernsey LS, et al. Repeated monitoring of corneal nerves by confocal microscopy as an index of peripheral neuropathy in type-1 diabetic rodents and the effects of topical insulin. Journal of the peripheral nervous system : JPNS. 2013;18(4):306-15. doi:10.1111/jns5.12044
Wu YC, Buckner BR, Zhu M, et al. Elevated IGFBP3 levels in diabetic tears: a negative regulator of IGF-1 signaling in the corneal epithelium. The ocular surface. 2012;10(2):100-7. doi:10.1016/j.jtos.2012.01.004
Göbbels M, Spitznas M, Oldendoerp J. Impairment of corneal epithelial barrier function in diabetics. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. 1989;227(2):142-4. doi:10.1007/bf02169787
Gekka M, Miyata K, Nagai Y, et al. Corneal epithelial barrier function in diabetic patients. Cornea. 2004;23(1):35-7. doi:10.1097/00003226-200401000-00006
Sanchis-Gimeno JA, Alonso L, Rahhal M, et al. Corneal thickness differences between type 2 diabetes and non-diabetes subjects during preoperative laser surgery examination. Journal of diabetes and its complications. 2017;31(1):209-212. doi:10.1016/j.jdiacomp.2016.08.024
Toygar O, Sizmaz S, Pelit A, et al. Central corneal thickness in type II diabetes mellitus: is it related to the severity of diabetic retinopathy? Turkish journal of medical sciences. 2015;45(3):651-4. doi:10.3906/sag-1404-153
Bao F, Deng M, Zheng X, et al. Effects of diabetes mellitus on biomechanical properties of the rabbit cornea. Experimental eye research. 2017;161:82-88. doi:10.1016/j.exer.2017.05.015
Calvo-Maroto AM, Perez-Cambrodi RJ, Garcia-Lazaro S, et al. Ocular autofluorescence in diabetes mellitus. A review. Journal of diabetes. 2016;8(5):619-28. doi:10.1111/1753-0407.12423
Scheler A, Spoerl E, Boehm AG. Effect of diabetes mellitus on corneal biomechanics and measurement of intraocular pressure. Acta ophthalmologica. 2012;90(6):e447-51. doi:10.1111/j.1755-3768.2012.02437.x
Wang X, Xu G, Wang W, et al. Changes in corneal biomechanics in patients with diabetes mellitus: a systematic review and meta-analysis. Acta diabetologica. 2020;57(8):973-981. doi: 10.1007/s00592-020-01481-0
Ozdamar Y, Cankaya B, Ozalp S, et al. Is there a correlation between diabetes mellitus and central corneal thickness? Journal of glaucoma. 2010;19(9):613-6. doi:10.1097/IJG.0b013e3181ca7c62
McNamara NA. Effects of diabetes on anterior ocular structure and function. International Contact Lens Clinic. 1997;24(3):81-90. doi:10.1016/S0892-8967(97)00019-9
Skeie JM, Aldrich BT, Goldstein AS, et al. Proteomic analysis of corneal endothelial cell-descemet membrane tissues reveals influence of insulin dependence and disease severity in type 2 diabetes mellitus. 2018;13(3):e0192287. doi:10.1371/journal.pone.0192287
Storr-Paulsen A, Singh A, Jeppesen H, et al. Corneal endothelial morphology and central thickness in patients with type II diabetes mellitus. Acta ophthalmologica. 2014;92(2):158-60. doi:10.1111/aos.12064
Lee JS, Oum BS, Choi HY, et al. Differences in corneal thickness and corneal endothelium related to duration in diabetes. Eye (London, England). 2006;20(3):315-8. doi:10.1038/sj.eye.6701868
Chen Y, Tsao SW, Heo M, et al. Age-Stratified Analysis of Diabetes and Pseudophakia Effects on Corneal Endothelial Cell Density: A Retrospective Eye Bank Study. Cornea. 2017;36(3):367-371. doi:10.1097/ico.0000000000001107
Islam QU, Mehboob MA, Amin ZA. Comparison of corneal morphological characteristics between diabetic and non diabetic population. Pakistan journal of medical sciences. 2017;33(6):1307-1311. doi:10.12669/pjms.336.13628
Chocron IM, Rai DK, Kwon JW, et al. Effect of Diabetes Mellitus and Metformin on Central Corneal Endothelial Cell Density in Eye Bank Eyes. Cornea. 2018;37(8):964-966. doi:10.1097/ico.0000000000001623
Liaboe CA, Aldrich BT, Carter PC, et al. Assessing the Impact of Diabetes Mellitus on Donor Corneal Endothelial Cell Density. Cornea. 2017;36(5):561-566. doi:10.1097/ico.0000000000001174
Mäkitie J, Koskenvuo M, Vannas A, et al. Corneal endothelium after photocoagulation in diabetic patients. Acta Ophthalmol (Copenh). 1985;63(3):355-60. doi:10.1111/j.1755-3768.1985.tb06820.x
Inoue K, Kato S, Inoue Y, et al. The corneal endothelium and thickness in type II diabetes mellitus. Japanese journal of ophthalmology. 2002;46(1):65-69. doi:
Morikubo S, Takamura Y, Kubo E, et al. Corneal changes after small-incision cataract surgery in patients with diabetes mellitus. Archives of ophthalmology (Chicago, Ill : 1960). 2004;122(7):966-9. doi:10.1001/archopht.122.7.966
Lee JS, Lee JE, Choi HY, et al. Corneal endothelial cell change after phacoemulsification relative to the severity of diabetic retinopathy. Journal of cataract and refractive surgery. 2005;31(4):742-9. doi:10.1016/j.jcrs.2004.09.035
Coskun M. Effects of Intravitreal Injection of Ranibizumab and Aflibercept on Corneal Endothelium and Central Corneal Thickness. Beyoglu Eye Journal. 2018;3(2):86-90. doi: 10.14744/bej.2018.03521
Friberg TR, Doran DL, Lazenby FL. The effect of vitreous and retinal surgery on corneal endothelial cell density. Ophthalmology. 1984;91(10):1166-9. doi:10.1016/s0161-6420(84)34166-5
Tsaousis KT, Panagiotou DZ, Kostopoulou E, et al. Corneal oedema after phacoemulsification in the early postoperative period: A qualitative comparative case-control study between diabetics and non-diabetics. Annals of medicine and surgery (2012). 2016;5:67-71. doi:10.1016/j.amsu.2015.12.047
Bron AJ, de Paiva CS, Chauhan SK, et al. TFOS DEWS II pathophysiology report. The ocular surface. 2017;15(3):438-510. doi:10.1016/j.jtos.2017.05.011
Seifart U, Strempel I. [The dry eye and diabetes mellitus]. Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 1994;91(2):235-9.
Kaiserman I, Kaiserman N, Nakar S, et al. Dry eye in diabetic patients. American journal of ophthalmology. 2005;139(3):498-503. doi:10.1016/j.ajo.2004.10.022
Hom M, De Land P. Self-reported dry eyes and diabetic history. Optometry (St Louis, Mo). 2006;77(11):554-8. doi:10.1016/j.optm.2006.08.002
Manaviat MR, Rashidi M, Afkhami-Ardekani M, et al. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients. BMC ophthalmology. 2008;8:10. doi:10.1186/1471-2415-8-10
Lv H, Li A, Zhang X, et al. Meta-analysis and review on the changes of tear function and corneal sensitivity in diabetic patients. Acta ophthalmologica. 2014;92(2):e96-e104. doi:10.1111/aos.12063
O'Donnell C, Efron N. Diabetes and contact lens wear. Clinical & experimental optometry. 2012;95(3):328-37. doi:10.1111/j.1444-0938.2012.00738.x
Alves Mde C, Carvalheira JB, Módulo CM, et al. Tear film and ocular surface changes in diabetes mellitus. Arquivos brasileiros de oftalmologia. 2008;71(6 Suppl):96-103. doi:10.1590/s0004-27492008000700018
Bikbova G, Oshitari T, Tawada A, et al. Corneal changes in diabetes mellitus. Current diabetes reviews. 2012;8(4):294-302. doi:10.2174/157339912800840479
Dogru M, Katakami C, Inoue M. Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus. Ophthalmology. 2001;108(3):586-92. doi:10.1016/s0161-6420(00)00599-6
Pershing S, Morrison DE, Hernandez-Boussard T. Cataract Surgery Complications and Revisit Rates Among Three States. American journal of ophthalmology. 2016;171:130-138. doi:10.1016/j.ajo.2016.08.036
Jiang D, Xiao X, Fu T, et al. Transient Tear Film Dysfunction after Cataract Surgery in Diabetic Patients. PloS one. 2016;11(1):e0146752. doi:10.1371/journal.pone.0146752
Liu X, Gu YS, Xu YS. Changes of tear film and tear secretion after phacoemulsification in diabetic patients. Journal of Zhejiang University Science B. 2008;9(4):324-8. doi:10.1631/jzus.B0710359
Ozdemir M, Buyukbese MA, Cetinkaya A, et al. Risk factors for ocular surface disorders in patients with diabetes mellitus. Diabetes research and clinical practice. 2003;59(3):195-9. doi:10.1016/s0168-8227(02)00244-9
Schultz RO, Van Horn DL, Peters MA, et al. Diabetic keratopathy. Transactions of the American Ophthalmological Society. 1981;79:180-99.
Spadea L, Paroli MP. Laser refractive surgery in diabetic patients: a review of the literature. Clinical ophthalmology (Auckland, NZ). 2012;6:1775-83. doi:10.2147/opth.s37384
Han SB, Yang HK, Hyon JY. Influence of diabetes mellitus on anterior segment of the eye. Clinical interventions in aging. 2019;14:53-63. doi:10.2147/cia.s190713
Fraunfelder FW, Rich LF. Laser-assisted in situ keratomileusis complications in diabetes mellitus. Cornea. 2002;21(3):246-8. doi:10.1097/00003226-200204000-00002
Cobo-Soriano R, Beltrán J, Baviera J. LASIK outcomes in patients with underlying systemic contraindications: a preliminary study. Ophthalmology. 2006;113(7):1118.e1-8. doi:10.1016/j.ophtha.2006.02.023
Ono T, Yuki K, Ozeki N, et al. Ocular surface complications after trabeculectomy: incidence, risk factors, time course and prognosis. Ophthalmologica Journal international d'ophtalmologie International journal of ophthalmology Zeitschrift fur Augenheilkunde. 2013;230(2):93-9. doi:10.1159/000351649
Brightbill FS, Myers FL, Bresnick GH. Postvitrectomy keratopathy. American journal of ophthalmology. 1978;85(5 Pt 1):651-5. doi:10.1016/s0002-9394(14)77099-0
Dogru M, Kaderli B, Gelisken O, et al. Ocular surface changes with applanation contact lens and coupling fluid use after argon laser photocoagulation in noninsulin-dependent diabetes mellitus. American journal of ophthalmology. 2004;138(3):381-8. doi:10.1016/j.ajo.2004.04.008
O'Donnell C, Efron N, Boulton AJ. A prospective study of contact lens wear in diabetes mellitus. Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists). 2001;21(2):127-38. doi:10.1046/j.1475-1313.2001.00555.x
O'Donnell C, Efron N. Corneal hydration control in contact lens wearers with diabetes mellitus. Optometry and vision science : official publication of the American Academy of Optometry. 2006;83(1):22-6. doi:10.1097/01.opx.0000195568.81052.c4
Giusti C. Transient hyperopic refractive changes in newly diagnosed juvenile diabetes. Swiss medical weekly. 2003;133(13-14):200-5.
Kaštelan S, Gverović-Antunica A, Pelčić G, et al. Refractive Changes Associated with Diabetes Mellitus. Seminars in ophthalmology. 2018;33(7-8):838-845. doi:10.1080/08820538.2018.1519582
Klein BE, Klein R, Moss SE. Incidence of cataract surgery in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. American journal of ophthalmology. 1995;119(3):295-300. doi:10.1016/s0002-9394(14)71170-5
Klein BE, Klein R, Wang Q, et al. Older-onset diabetes and lens opacities. The Beaver Dam Eye Study. Ophthalmic epidemiology. 1995;2(1):49-55. doi:10.3109/09286589509071451
Raman R, Pal SS, Adams JS, et al. Prevalence and risk factors for cataract in diabetes: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study, report no. 17. Investigative ophthalmology & visual science. 2010;51(12):6253-61. doi:10.1167/iovs.10-5414
Kinoshita JH. Mechanisms initiating cataract formation. Proctor Lecture. Investigative ophthalmology. 1974;13(10):713-24.
Takamura Y, Sugimoto Y, Kubo E, et al. Immunohistochemical study of apoptosis of lens epithelial cells in human and diabetic rat cataracts. Jpn J Ophthalmol. 2001;45(6):559-63. doi:10.1016/s0021-5155(01)00418-x
Agte VV, Tarwadi KV. Combination of diabetes and cataract worsens the oxidative stress and micronutrient status in Indians. Nutrition (Burbank, Los Angeles County, Calif). 2008;24(7-8):617-24. doi:10.1016/j.nut.2008.03.005
Ookawara T, Kawamura N, Kitagawa Y, et al. Site-specific and random fragmentation of Cu,Zn-superoxide dismutase by glycation reaction. Implication of reactive oxygen species. The Journal of biological chemistry. 1992;267(26):18505-10. doi:
Hreidarsson AB. Pupil motility in long-term diabetes. Diabetologia. 1979;17(3):145-50. doi:10.1007/bf01219740
Smith SA, Smith SE. Evidence for a neuropathic aetiology in the small pupil of diabetes mellitus. The British journal of ophthalmology. 1983;67(2):89-93. doi:10.1136/bjo.67.2.89
Huber MJ, Smith SA, Smith SE. Mydriatic drugs for diabetic patients. The British journal of ophthalmology. 1985;69(6):425-7. doi:10.1136/bjo.69.6.425
Masket S, Belani S. Combined preoperative topical atropine sulfate 1% and intracameral nonpreserved epinephrine hydrochloride 1:4000 [corrected] for management of intraoperative floppy-iris syndrome. Journal of cataract and refractive surgery. 2007;33(4):580-2. doi:10.1016/j.jcrs.2006.10.059
Joshi RS. Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes. Clinical ophthalmology (Auckland, NZ). 2016;10:2427-2432. doi:10.2147/opth.s122107
Tian JJ, Garcia GA, Karanjia R, et al. Comparison of 2 pupil expansion devices for small-pupil cataract surgery. Journal of cataract and refractive surgery. 2016;42(8):1235-7. doi:10.1016/j.jcrs.2016.07.002
Fernández-Rubio ME, Rebolledo-Lara L, Martinez-García M, et al. The conjunctival bacterial pattern of diabetics undergoing cataract surgery. Eye (London, England). 2010;24(5):825-34. doi:10.1038/eye.2009.218
Karimsab D, Razak SK. Study of aerobic bacterial conjunctival flora in patients with diabetes mellitus. Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH. 2013;5(1):28-32. doi:10.3126/nepjoph.v5i1.7818
Kruse A, Thomsen RW, Hundborg HH, et al. Diabetes and risk of acute infectious conjunctivitis--a population-based case-control study. Diabetic medicine : a journal of the British Diabetic Association. 2006;23(4):393-7. doi:10.1111/j.1464-5491.2006.01812.x
Scott IU, Flynn HW, Jr., Feuer W. Endophthalmitis after secondary intraocular lens implantation. A case-report study. Ophthalmology. 1995;102(12):1925-31. doi:10.1016/s0161-6420(95)30774-9
Doft BH, Wisniewski SR, Kelsey SF, et al. Diabetes and postcataract extraction endophthalmitis. Current opinion in ophthalmology. 2002;13(3):147-51. doi:10.1097/00055735-200206000-00003
Chu CJ, Johnston RL, Buscombe C, et al. Risk Factors and Incidence of Macular Edema after Cataract Surgery: A Database Study of 81984 Eyes. Ophthalmology. 2016;123(2):316-323. doi:10.1016/j.ophtha.2015.10.001
Modjtahedi BS, Paschal JF, Batech M, et al. Perioperative Topical Nonsteroidal Anti-inflammatory Drugs for Macular Edema Prophylaxis Following Cataract Surgery. American journal of ophthalmology. 2017;176:174-182. doi:10.1016/j.ajo.2017.01.006
Yang J, Cai L, Sun Z, et al. Risk factors for and diagnosis of pseudophakic cystoid macular edema after cataract surgery in diabetic patients. Journal of cataract and refractive surgery. 2017;43(2):207-214. doi:10.1016/j.jcrs.2016.11.047
Suto C, Hori S, Kato S. Management of type 2 diabetics requiring panretinal photocoagulation and cataract surgery. Journal of cataract and refractive surgery. 2008;34(6):1001-6. doi:10.1016/j.jcrs.2008.02.019
Juthani VV, Clearfield E, Chuck RS. Non-steroidal anti-inflammatory drugs versus corticosteroids for controlling inflammation after uncomplicated cataract surgery. The Cochrane database of systematic reviews. 2017;7(7):Cd010516. doi:10.1002/14651858.CD010516.pub2
Yavas GF, Oztürk F, Küsbeci T. Preoperative topical indomethacin to prevent pseudophakic cystoid macular edema. Journal of cataract and refractive surgery. 2007;33(5):804-7. doi:10.1016/j.jcrs.2007.01.033
Singh R, Alpern L, Jaffe GJ, et al. Evaluation of nepafenac in prevention of macular edema following cataract surgery in patients with diabetic retinopathy. Clinical ophthalmology (Auckland, NZ). 2012;6:1259-69. doi:10.2147/opth.s31902
Chastain JE, Sanders ME, Curtis MA, et al. Distribution of topical ocular nepafenac and its active metabolite amfenac to the posterior segment of the eye. Experimental eye research. 2016;145:58-67. doi:10.1016/j.exer.2015.10.009
Laursen SB, Erichsen JH, Holm LM, et al. Prevention of macular edema in patients with diabetes after cataract surgery. Journal of cataract and refractive surgery. 2019;45(6):854-869. doi:10.1016/j.jcrs.2019.04.025
Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Archives of ophthalmology (Chicago, Ill : 1960). 1985;103(12):1796-806.
Moshfeghi AA, Shapiro H, Lemmon LA, et al. Impact of Cataract Surgery during Treatment with Ranibizumab in Patients with Diabetic Macular Edema. Ophthalmology Retina. 2018;2(2):86-90. doi:10.1016/j.oret.2017.05.003
Boyer DS, Yoon YH, Belfort R, Jr., et al. Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema. Ophthalmology. 2014;121(10):1904-14. doi:10.1016/j.ophtha.2014.04.024
Furino C, Boscia F, Niro A, et al. Combined phacoemulsification and intravitreal dexamethasone implant (Ozurdex®) in diabetic patients with coexisting cataract and diabetic macular edema. Journal of ophthalmology. 2017;2017. doi:10.1155/2017/4896036
Akinci A, Muftuoglu O, Altınsoy A, et al. Phacoemulsification with intravitreal bevacizumab and triamcinolone acetonide injection in diabetic patients with clinically significant macular edema and cataract. Retina (Philadelphia, Pa). 2011;31(4):755-8. doi:10.1097/IAE.0b013e3182006da1
Alessio G, Boscia F, Caporossi A, et al. Dexamethasone implants in patients with diabetic macular edema undergoing cataract surgery: Italian expert panel consensus statements. European journal of ophthalmology. 2021;31(3):1122-1127. doi:10.1177/1120672120939500
Furino C, Boscia F, Niro A, et al. DIABETIC MACULAR EDEMA AND CATARACT SURGERY: Phacoemulsification Combined With Dexamethasone Intravitreal Implant Compared With Standard Phacoemulsification. Retina (Philadelphia, Pa). 2021;41(5):1102-1109. doi:10.1097/iae.0000000000002974
Chew EY, Benson WE, Remaley NA, et al. Results after lens extraction in patients with diabetic retinopathy: early treatment diabetic retinopathy study report number 25. Archives of ophthalmology (Chicago, Ill : 1960). 1999;117(12):1600-6. doi:10.1001/archopht.117.12.1600
Squirrell D, Bhola R, Bush J, et al. A prospective, case controlled study of the natural history of diabetic retinopathy and maculopathy after uncomplicated phacoemulsification cataract surgery in patients with type 2 diabetes. The British journal of ophthalmology. 2002;86(5):565-71. doi:10.1136/bjo.86.5.565
Hong T, Mitchell P, de Loryn T, et al. Development and progression of diabetic retinopathy 12 months after phacoemulsification cataract surgery. Ophthalmology. 2009;116(8):1510-4. doi:10.1016/j.ophtha.2009.03.003
Shah AS, Chen SH. Cataract surgery and diabetes. Current opinion in ophthalmology. 2010;21(1):4-9. doi:10.1097/ICU.0b013e328333e9c1
Murtha T, Cavallerano J. The management of diabetic eye disease in the setting of cataract surgery. Current opinion in ophthalmology. 2007;18(1):13-8. doi:10.1097/ICU.0b013e32801129fc
Zaczek A, Olivestedt G, Zetterström C. Visual outcome after phacoemulsification and IOL implantation in diabetic patients. The British journal of ophthalmology. 1999;83(9):1036-41. doi:10.1136/bjo.83.9.1036
Hayashi K, Hayashi H, Nakao F, et al. Posterior capsule opacification after cataract surgery in patients with diabetes mellitus. American journal of ophthalmology. 2002;134(1):10-6. doi:10.1016/s0002-9394(02)01461-7
Ebihara Y, Kato S, Oshika T, et al. Posterior capsule opacification after cataract surgery in patients with diabetes mellitus. Journal of cataract and refractive surgery. 2006;32(7):1184-7. doi:10.1016/j.jcrs.2006.01.100
Praveen MR, Vasavada AR, Shah GD, et al. A prospective evaluation of posterior capsule opacification in eyes with diabetes mellitus: a case-control study. Eye (London, England). 2014;28(6):720-7. doi:10.1038/eye.2014.60
Nishi O, Nishi K, Osakabe Y. Effect of intraocular lenses on preventing posterior capsule opacification: design versus material. Journal of cataract and refractive surgery. 2004;30(10):2170-6. doi:10.1016/j.jcrs.2004.05.022
Eaton AM, Jaffe GJ, McCuen BW, 2nd, et al. Condensation on the posterior surface of silicone intraocular lenses during fluid-air exchange. Ophthalmology. 1995;102(5):733-6. doi:10.1016/s0161-6420(95)30961-x
Lee DH, Seo Y, Joo CK. Progressive opacification of hydrophilic acrylic intraocular lenses in diabetic patients. Journal of cataract and refractive surgery. 2002;28(7):1271-5. doi:10.1016/s0886-3350(02)01245-2
Rodríguez-Galietero A, Montés-Micó R, Muñoz G, et al. Blue-light filtering intraocular lens in patients with diabetes: contrast sensitivity and chromatic discrimination. Journal of cataract and refractive surgery. 2005;31(11):2088-92. doi:10.1016/j.jcrs.2005.04.029
Braga-Mele R, Chang D, Dewey S, et al. Multifocal intraocular lenses: relative indications and contraindications for implantation. Journal of cataract and refractive surgery. 2014;40(2):313-22. doi:10.1016/j.jcrs.2013.12.011
Narendran N, Jaycock P, Johnston RL, et al. The Cataract National Dataset electronic multicentre audit of 55,567 operations: risk stratification for posterior capsule rupture and vitreous loss. Eye (London, England). 2009;23(1):31-7. doi:10.1038/sj.eye.6703049
Chancellor J, Soliman MK, Shoults CC, et al. Intraoperative Complications and Visual Outcomes of Cataract Surgery in Diabetes Mellitus: A Multicenter Database Study. American journal of ophthalmology. 2021;225:47-56. doi:10.1016/j.ajo.2020.12.027
Mittra RA, Borrillo JL, Dev S, et al. Retinopathy progression and visual outcomes after phacoemulsification in patients with diabetes mellitus. Archives of ophthalmology (Chicago, Ill : 1960). 2000;118(7):912-7. doi:10-1001/pubs.Ophthalmol
Zare M, Javadi MA, Einollahi B, et al. Risk Factors for Posterior Capsule Rupture and Vitreous Loss during Phacoemulsification. Journal of ophthalmic & vision research. 2009;4(4):208-12.
Lee AY, Day AC, Egan C, et al. Previous Intravitreal Therapy Is Associated with Increased Risk of Posterior Capsule Rupture during Cataract Surgery. Ophthalmology. 2016;123(6):1252-6. doi:10.1016/j.ophtha.2016.02.014
Dawson VJ, Patnaik J, Wildes M, et al. The Risk of Posterior Capsule Rupture in Patients with Type 2 Diabetes Mellitus and Diabetic Retinopathy During Phacoemulsification Cataract Surgery. Investigative ophthalmology & visual science. 2021;62(8):564-564. doi:10.1111/aos.15121
Hayreh SS. Neovascular glaucoma. Progress in retinal and eye research. 2007;26(5):470-85. doi:10.1016/j.preteyeres.2007.06.001
Sayin N, Kara N, Pekel G. Ocular complications of diabetes mellitus. World journal of diabetes. 2015;6(1):92-108. doi:10.4239/wjd.v6.i1.92
Chopra V, Varma R, Francis BA, et al. Type 2 diabetes mellitus and the risk of open-angle glaucoma the Los Angeles Latino Eye Study. Ophthalmology. 2008;115(2):227-232.e1. doi:10.1016/j.ophtha.2007.04.049
de Voogd S, Ikram MK, Wolfs RC, et al. Is diabetes mellitus a risk factor for open-angle glaucoma? The Rotterdam Study. Ophthalmology. 2006;113(10):1827-31. doi:10.1016/j.ophtha.2006.03.063
Zhao D, Cho J, Kim MH, et al. Diabetes, fasting glucose, and the risk of glaucoma: a meta-analysis. Ophthalmology. 2015;122(1):72-8. doi:10.1016/j.ophtha.2014.07.051
Newman-Casey PA, Talwar N, Nan B, et al. The relationship between components of metabolic syndrome and open-angle glaucoma. Ophthalmology. 2011;118(7):1318-26. doi:10.1016/j.ophtha.2010.11.022
Lim HB, Shin YI, Lee MW, et al. Longitudinal Changes in the Peripapillary Retinal Nerve Fiber Layer Thickness of Patients With Type 2 Diabetes. JAMA ophthalmology. 2019;137(10):1125-1132. doi:10.1001/jamaophthalmol.2019.2537
Law SK, Hosseini H, Saidi E, et al. Long-term outcomes of primary trabeculectomy in diabetic patients with primary open angle glaucoma. The British journal of ophthalmology. 2013;97(5):561-6. doi:10.1136/bjophthalmol-2012-302227
Saw SM, Wong TY, Ting S, et al. The relationship between anterior chamber depth and the presence of diabetes in the Tanjong Pagar Survey. American journal of ophthalmology. 2007;144(2):325-6. doi:10.1016/j.ajo.2007.03.038
Senthil S, Garudadri C, Khanna RC, et al. Angle closure in the Andhra Pradesh Eye Disease Study. Ophthalmology. 2010;117(9):1729-35. doi:10.1016/j.ophtha.2010.01.021
Chen HY, Lin CL. Comparison of medical comorbidity between patients with primary angle-closure glaucoma and a control cohort: a population-based study from Taiwan. BMJ open. 2019;9(3):e024209. doi:10.1136/bmjopen-2018-024209
Blondeau P, Pavan PR, Phelps CD. Acute pressure elevation following panretinal photocoagulation. Archives of ophthalmology (Chicago, Ill : 1960). 1981;99(7):1239-41. doi:10.1001/archopht.1981.03930020113011
Biousse V, Newman NJ. Ischemic Optic Neuropathies. The New England journal of medicine. 2015;372(25):2428-36. doi:10.1056/NEJMra1413352
Chen T, Song D, Shan G, et al. The association between diabetes mellitus and nonarteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis. PloS one. 2013;8(9):e76653. doi:10.1371/journal.pone.0076653
Sharma S, Kwan S, Fallano KA, et al. Comparison of Visual Outcomes of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients with and without Diabetes Mellitus. Ophthalmology. 2017;124(4):450-455. doi:10.1016/j.ophtha.2016.11.029
Bayraktar Z, Alacali N, Bayraktar S. Diabetic papillopathy in type II diabetic patients. Retina (Philadelphia, Pa). 2002;22(6):752-8. doi:10.1097/00006982-200212000-00011
Slagle WS, Musick AN, Eckermann DR. Diabetic papillopathy and its relation to optic nerve ischemia. Optometry and vision science : official publication of the American Academy of Optometry. 2009;86(4):e395-403. doi:10.1097/OPX.0b013e318198927c
Ostri C. Intraocular surgery in a large diabetes patient population: risk factors and surgical results. Acta ophthalmologica. 2014;92 Thesis1:1-13. doi:10.1111/aos.12364
Greco D, Gambina F, Maggio F. Ophthalmoplegia in diabetes mellitus: a retrospective study. Acta diabetologica. 2009;46(1):23-6. doi:10.1007/s00592-008-0053-8
Patel SV, Holmes JM, Hodge DO, et al. Diabetes and hypertension in isolated sixth nerve palsy: a population-based study. Ophthalmology. 2005;112(5):760-3. doi:10.1016/j.ophtha.2004.11.057
Wang Y, Wu S, Wen F, et al. Diabetes mellitus as a risk factor for retinal vein occlusion: A meta-analysis. Medicine. 2020;99(9):e19319. doi:10.1097/md.0000000000019319
Santiago JG, Walia S, Sun JK, et al. Influence of diabetes and diabetes type on anatomic and visual outcomes following central rein vein occlusion. Eye (London, England). 2014;28(3):259-68. doi:10.1038/eye.2014.1
Scott IU, Campochiaro PA, Newman NJ, et al. Retinal vascular occlusions. Lancet (London, England). 2020;396(10266):1927-1940. doi:10.1016/s0140-6736(20)31559-2
Chang Y-S, Ho C-H, Chu C-C, et al. Risk of retinal artery occlusion in patients with diabetes mellitus: a retrospective large-scale cohort study. PloS one. 2018;13(8):e0201627. doi:10.1371/journal.pone.0201627
