When managing the cataract of a patient with diabetes, you should remember that cataract surgery may make diabetic retinopathy worse. Eyes with mild to moderate non-proliferative diabetic retinopathy at the time of surgery are considered less at risk. Those with severe non-proliferative and proliferative diabetic retinopathy have a higher risk of progressive disease. Clinically significant macular oedema (CSMO) present at the time of surgery is likely to progress and eyes with previously treated CSMO are at increased risk of recurrence. The risk of progression is increased if the operation is complicated by excessive manipulation, vitreous loss, or severe post-operative inflammation
