Are Visual Outcomes After Cataract Surgery Different in Diabetic Patients Compared with Non-Diabetic Patients?: A Retrospective Study in a Tertiary Hospital in Saudi Arabia

Naif Alruwais, Shahad F Altayash, Rizwan Malik, Syed J RahemanDepartment of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Naif Alruwais, Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, Email Alruwais.naif0@gmail.comBackground: Cataract surgery is a common procedure that dramatically improves visual clarity. The outcomes for patients with diabetes can be sensitive to various health conditions such as diabetic retinopathy and macular edema. This investigation set out to evaluate and compare post-cataract surgery visual acuity outcomes between diabetic and non-diabetic controls and to evaluate relevant structural and surgical parameters.Methods: This retrospective observational study was conducted at King Khaled Eye Specialist Hospital (KKESH), where 200 eyes (100 diabetic patients and 100 non-diabetic patients) who were treated with phacoemulsification during October and November 2025 were included. Best-corrected visual acuity (BCVA), central macular thickness (CMT), macular edema and surgical results were examined in the analysis.Results: No statistically significant differences in postoperative BCVA were observed between diabetic and non-diabetic patients at one month (0.56 ± 0.39 vs 0.51 ± 0.42 logMAR, p = 0.338) or at final follow-up (0.44 ± 0.41 vs 0.43 ± 0.44 logMAR, p = 0.698). However, diabetic patients demonstrated significantly higher rates of postoperative macular edema (19.0% vs 6.0%, p = 0.005) and greater CMT values (289.17 ± 142.37 μm vs 253.81 ± 67.92 μm, p = 0.026). Progression of diabetic retinopathy was observed in 4% of diabetic eyes during follow-up. No statistically significant association was identified between surgeon experience level and postoperative visual outcomes or complication rates.Conclusion: Although visual acuity outcomes after cataract surgery are similar in diabetic and non-diabetic patients, those with diabetes show a greater prevalence of macular structural changes. It is recommended to conduct thorough preoperative evaluations and postoperative monitoring for macular complications in diabetic patients.Keywords: cataract surgery, diabetes mellitus, diabetic retinopathy, macular edema, visual acuity outcomes