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PURPOSE: To compare the visual outcome and the rate of intraoperative complications in eyes of diabetic and non-diabetic patients undergoing phacoemulsification over 15 years DESIGN: Retrospective clinical cohort study METHODS: Data of 179,159 eyes that underwent phacoemulsification at 8 centers were classified based on the presence or absence of diabetes mellitus. Visual acuity (VA) was defined as the best value of uncorrected or corrected distance measure available. For the VA analysis, eyes with co-pathologies, or combined surgical procedures were further excluded, leaving a subset of 90,729 eyes. Main outcome measures were logarithm of the minimum angle of resolution (logMAR) VA at 4-12 weeks postoperatively, and rate of intraoperative complications.RESULTS: Cataract surgery in eyes of diabetic patients was associated with an improvement in mean VA of 0.48 LogMAR (5 Snellen lines). Mean postoperative VA was slightly worse in diabetic compared to non-diabetic group (logMAR 0.23 vs. 0.13; Snellen 20/30 vs. 20/25; p < 0.0001) and the proportions of eyes achieving a visual gain of ≥3 Snellen lines (≥ 0.3 logMAR) was lower in the diabetic group (56.6% vs. 63.5%; p < 0.0001). There was a linear relationship between diabetic retinopathy severity and worse postoperative visual acuity (β coefficient 0.098 to 0.288; p < 0.0001). We observed higher rates of posterior capsule rupture (2.3% vs.1.6%; p CONCLUSIONS: Postoperative VA negatively correlated with diabetes and diabetic retinopathy severity. Eyes of diabetic subjects had higher risks of posterior capsular rupture.

Background: Various techniques are used across institutions for implantation of deep brain stimulation (DBS) leads. The most used techniques for each step include preoperative MRI fused to in-frame CT, intraoperative fluoroscopy, and postoperative CT, but postimplantation MRI also is used, as it was at our center. We present the quality assurance study performed at our institution after a change from postimplantation MRI performed across the hospital to postimplantation in room CT. Methods: Retrospective chart review of 123 patients who underwent bilateral DBS leads placement without same-day generator placement that was performed. The patients were divided by the type of postoperative imaging that was obtained. Patients were excluded if a unilateral lead placement was performed, if the case was a revision of an existing lead or deviated from the normal protocol. Operative room times and procedure times for each group were analyzed with Wilcoxon rank sums test (WRST) to determine any significant differences between groups. Results: Postoperative MRI was performed for 82 patients, while postoperative CT was performed for 41 patients. A WRST showed a significant reduction in both operative room time (209 min to 170 min, P < 0.0001) and procedure time (140 min to 126 min, P = 0.0019). Conclusion: In-room CT allowed for a significant reduction in operative room time. Lower operative room time has been associated with increased patient comfort, and decreased cost. CT did not alter the revision rate for procedures. The significant reduction in procedure time may be attributed to increased team familiarity with procedure over time.