Visual Outcomes and Complication Profiles of Phacoemulsification in Diabetic Versus Non-diabetic Patients.

Abstract

Diabetic patients undergoing phacoemulsification for cataracts face an elevated risk of intraoperative and postoperative complications due to systemic and ocular pathophysiological changes. This narrative review aims to systematically compare visual outcomes and complication profiles between diabetic and non-diabetic individuals following phacoemulsification, while identifying current best practices and future research directions. With rising global diabetes prevalence, cataract surgery in diabetic patients is increasingly common. Understanding the interaction between diabetes-related ocular changes and phacoemulsification outcomes is vital for improving surgical planning, reducing complications, and enhancing patient satisfaction. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science using Medical Subject Headings (MeSH) and free-text terms. Eligible studies from 2020 to 2025 were selected based on predefined criteria. Data were narratively synthesized across themes, including intraoperative challenges, visual acuity outcomes, macular health, adjunctive therapies, and long-term prognosis. Diabetic patients exhibit higher risks of poor pupil dilation, capsular fragility, macular edema, and slower visual recovery. However, with good glycemic control, preoperative retinal evaluation, and adjunctive therapies, outcomes can closely approximate those of non-diabetics. Tailored perioperative management and interdisciplinary care models are critical for optimizing outcomes in diabetic cataract surgery. Future studies should focus on stratified risk assessment and long-term visual prognosis.