Abstract: Objective To evaluate the influence of cataract phacoemulsification on progression of diabetic retinopathy (DR) and occurrence of diabetic macular edema (DME) in diabetic patients. Design Systemic review. Participants Published literatures in Medline, EMbase, Cochrane library and CBM which comparing the progression of DR and DME between the eyes accepted the cataract phacoemulsification and the fellow eyes which were not accepted the surgeries. Methods This was a meta-analysis of prospective paired cohort study. A computerized search was performed in the databases with manually searching of bibliographies of pertinent articles, journals and literature reference proceedings. According to inclusion and exclusion criteria, data extraction was conducted from included studies. The statistical analysis was performed by software RevMan5.0. The odds ratio (OR) and 95% confidence interval (CI) was calculated for dichotomous variables. Main Outcome Measures Progression of diabetic retinopathy， and occurrence of diabetic macular edema after cataract phacoemulsification. Results Totally seven studies were included in the Meta-analysis involving 579 operated eyes and 574 non-operated contralateral eyes. The operated eyes gained a higher progression rate of diabetic retinopathy than the non-operated eyes (OR=1.47, 95%CI: 1.09~1.98, P=0.01). The similar result was achieved on the occurrence of diabetic macular edema (OR=1.89, 95%CI: 1.05~3.39, P=0.03). Conclusion  Cataract phacoemulsification could accelerate the progression of diabetic retinopathy and increase the incidence of diabetic macular edema. However a high-quality, large sample and long-term clinical trials are warranted to be further investigated.

Key words: phacoemulsification, diabetic retinopathy, diabetic macular edema, Mata-analysis