The vast majority of lens opacities in adult diabetics are nuclear sclerotic in type, but they do progress more rapidly and become symptomatic at a younger age than in nondiabetics.
The preoperative cataract evaluation of a diabetic should include;
A potential acuity meter measurement,
Retinal assessment,
When deemed necessary, a fluorescein angiogram.
Pre-existing active retinopathy with macular edema portends poor visual results.
Intraoperative difficulties include:
Increased endothelial and iris pigment epithelial fragility.
Increased vascular leakage and inflammation, fibrin deposition.
Increased vulnerability to operating microscope light injury.
Postoperative problems may include:
Increased risk of synechia formation and pupillary block,
Cystoid macular edema,
Rapid development of capsular thickening, and increased risk of vitreous hemorrhage.