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Postoperative fibrinoid reaction in extracapsular surgery with intraocular lens implantation in diabetic retinopathy patients.

IOL implantation in diabetic retinopathy patients is still controversial. To ascertain the frequency of inflammatory complications in diabetic patients and the influence of such surgery on the evolution and treatment of diabetic retinopathy, the authors have reviewed 198 consecutive diabetic eyes (120 operated patients) with extracapsular cataract extraction and posterior chamber intraocular lens implantation. The mean follow-up period was 26 months with a range from 19 to 36 months. Postoperative visual acuity was 0.45. The incidence of inflammatory reaction with fibrinoid component was 3.03% vs 2.5% in a matched control group. Intensive topical corticosteroid treatment was effective in controlling the inflammatory reaction in all cases within one to three days. The diabetic retinopathy did not show an increase in progression after IOL implantation but in one case with severe postoperative inflammatory reaction. Photocoagulation postoperatively was indicated in all cases, being effective in all but the case in which retinopathy got worse; this case required vitrectomy with endophotocoagulation because of vitreous haziness. Visual acuity improved following cataract surgery regardless of the incidence of inflammation or the type of diabetic retinopathy.