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Can people with diabetes have cataract surgery?

Diabetes is very common in Goa. The ICMR-INDIAB study (2023) found diabetes in 26.4% of adults in Goa, one of the highest rates in India. So many people who need cataract surgery here also have diabetes, and they and their families have good questions about sugar levels, safety and recovery. This guide answers them. For an overview of cataract care, see cataract surgery in Vasco, Goa.

Why does diabetes bring cataract earlier?

When blood sugar stays high, extra sugar enters the natural lens of the eye. Over time this changes the lens proteins and draws in water, and the lens clouds sooner than it otherwise would. People with diabetes tend to develop cataract at a younger age, and it can grow faster. A type of cataract at the back of the lens, which troubles reading and bright light early, is more common in diabetes.

High or unsteady sugar can also make the lens swell for a time and change your spectacle power from week to week. This is one reason the eye doctor checks how well your diabetes is controlled before prescribing new spectacles.

Is cataract surgery safe if I have diabetes?

Cataract surgery is commonly done in people with diabetes. The risks are somewhat higher than in people without diabetes, and good planning lowers them. The main concerns are:

• Swelling at the centre of the retina (macular oedema), which can blur vision after surgery
• Diabetic retinopathy getting worse after surgery in an eye that already has it
• Infection and inflammation, which are more likely when sugar is poorly controlled
• Slower healing of the eye's surface

Our eye surgeon explains the risks for your own eyes before you decide.

What sugar level is needed for cataract surgery?

There is no single number that applies to everyone, so we do not give one here. The surgeon looks at your recent sugar reports, often including HbA1c (a three-month average), together with your general health and your physician's advice. What matters most is steady control in the weeks before surgery and on the day itself.

• Keep taking your diabetes tablets or insulin as your physician advises. Do not stop or change them on your own.
• Do not try a crash diet before surgery; sudden low sugar is also risky.
• Ask your physician how to adjust your medicines on the morning of surgery.
• Bring your sugar reports, medicine list, and a small snack or sweet in case your sugar drops while you wait.

If your sugar is very high on the day, the surgeon may postpone the operation until it is better controlled. This is for your safety.

Why is a retina check needed before surgery?

Diabetes can damage the small blood vessels of the retina, the light-sensing layer at the back of the eye (diabetic retinopathy). Before cataract surgery, our eye surgeon examines the retina after dilating drops to see whether retinopathy or macular swelling is present. Sometimes a dense cataract blocks the view, and surgery itself helps the doctor see and look after the retina better.

If the retina needs laser or injection treatment, ReNew Vision refers you to a retina centre for that step, and the timing of your cataract surgery is planned around it. We continue your diabetic eye check-ups here.

Which lens suits an eye with diabetes?

A monofocal lens suits most eyes with diabetes. A multifocal lens may not be advised if there is retinopathy or macular swelling, because it needs a healthy retina to work well. A toric lens can be used for astigmatism if the eye is otherwise suitable. Read choosing a lens for cataract surgery.

What extra care is needed after surgery?

• Use your eye drops exactly as prescribed, without missing doses.
• Keep your sugar steady; healing is better when it is controlled.
• Come for every follow-up visit, including a retina check after surgery.
• Tell us if your vision improves at first and then becomes blurred again, which can be a sign of retina swelling.
• Keep the eye clean and dry, and avoid rubbing it.

The general advice is in precautions after cataract surgery. If you notice increasing pain, worsening vision, increasing redness or discharge, call at once, day or night: emergency eye care is available 24 hours; see eye emergency.

What about the other eye?

Diabetes usually affects both eyes, so many people need cataract surgery in both. The second eye is usually done after the first has settled; read the gap between surgery on both eyes.

How can I protect my eyes with diabetes?

• Have a diabetic eye check-up with dilating drops at least once a year, or more often if advised, even when you see well.
• Keep sugar, blood pressure and cholesterol under control.
• Do not smoke.
• Wear sunglasses and a hat in strong sun.

Diabetic eye check-ups are part of our eye check-up service. ReNew Vision Eye Hospital, Vaddem, Vasco da Gama: eye OPD Monday to Saturday, 4 pm to 7 pm. Call or WhatsApp 072489 88039.

Questions patients ask

What sugar level is needed for cataract surgery?

There is no single number for everyone. The surgeon looks at your recent sugar reports and HbA1c with your physician's advice. What matters most is steady control in the weeks before surgery and on the day.

Should I stop my diabetes tablets or insulin before cataract surgery?

Do not stop them on your own. Keep taking them as your physician advises, and ask how to adjust them on the morning of surgery, so that your sugar does not go too high or too low.

Does diabetes make cataract surgery riskier?

Somewhat. Swelling of the retina, infection and worsening of diabetic retinopathy are more likely, especially when sugar is poorly controlled. A retina check before surgery and careful follow-up help lower these risks.

Why does my spectacle power change when my sugar is high?

High or unsteady sugar can make the natural lens swell for a time, which changes the spectacle power. That is why new spectacles are prescribed once your sugar is steady.

How often should a person with diabetes have an eye check-up?

At least once a year, with dilating drops so that the retina can be examined, or more often if your eye doctor advises. Have it even if you see well.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.