Retrospective Study In Intermediate Distance Visual Outcome In Diabetic Patients After Technis Eyhance Iol Implantation In Cataract Surgery

The application of TECNIS Eyhance IOL in diabetic retinopathy or maculopathy patients poses a unique challenge due to the presence of co-existing retinal pathology. Limited data has led to a lack of evidence guiding the use of this IOL in such populations. With diabetic retinopathy being a common complication, and diabetic patients experiencing cataractogenesis more frequently and earlier, the need for optimised post-cataract visual outcomes in this demographic becomes increasingly imperative. This audit aims to bridge the gap in evidence by evaluating the intermediate distance vision outcomes following TECNIS Eyhance IOL implantation in diabetic retinopathy or maculopathy patients undergoing cataract surgery.

This audit adopts a retrospective observational study design, encompassing a cohort of diabetic retinopathy or maculopathy patients who underwent cataract surgery with subsequent TECNIS Eyhance IOL implantation at Colchester Eye Centre from 19^th February 2023 to 20^th February 2024. This audit adheres to the principles outlined in the Declaration of Helsinki and complies with institutional data protection and patient confidentiality guidelines. 

Inclusion criteria were diabetes mellitus patients,aged 18 years and above,had cataract surgery with TECNIS Eyhance IOL implantation,comparable visual acuity measurement available in pre-operative and 3 months post-operative data. Patients were excluded if they had incomplete data records,other ocular comorbidities affecting vision,previous ocular surgeries except cataract extraction,or less than 3 months follow-up duration.Data was extracted from MediSight MediSoft database.Parameters included age,gender,pre-operative visual acuity,severity of diabetic retinopathy,post-operative visual acuity at intermediate distance, and complications.Measured outcomes were patient's reported use of glasses after IOL implantation and their visual acuity. 

A total of 75 patients met the inclusion criteria.There were 44 males and 31 females.The mean age was 72.93±10.94 years. Mean age for males was 73.21±11.01years,whilst for females was 73.09±10.97 years.Clinicians have recorded 22 patients without retinopathy,18 patients have mild diabetic retinopathy (DR)(56%),8 have moderate DR(25%),2 have severe DR(6%),3 have proliferative DR(9%),1 have advanced proliferative DR(3%).19 patients have maculopathies.

The mean pre-operative best corrected visual acuity(BCVA) at intermediate distance was 0.52±0.48 logMAR. The mean post-operative BCVA improved to 0.34±0.43logMAR. Majority of patients (42%) answered wearing glasses all of the time, 30% answered some of the time, 24% answered none at all.

The results showed significant improvement in intermediate distance visual acuity post-operatively suggests the potential efficacy of TECNIS Eyhance IOL in diabetic patients. However, there is still discrepancy between objective and subjective visual outcome measurements.