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Glycemic control and macular edema in patients undergoing cataract surgery

  • Author Footnotes
    1 Equal contribution.
    Amit Rachmilevich
    Footnotes
    1 Equal contribution.
    Affiliations
    Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel
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  • Author Footnotes
    1 Equal contribution.
    Noam Yanculovich
    Footnotes
    1 Equal contribution.
    Affiliations
    Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel

    Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O.B. 635, Beer-Sheva 8410501, Israel
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  • Itai Hazan
    Affiliations
    Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel

    Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 635, Beer-Sheva 8410501, Israel
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  • Erez Tsumi
    Affiliations
    Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel

    Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O.B. 635, Beer-Sheva 8410501, Israel
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  • Idit F. Liberty
    Correspondence
    Correspondence to: Diabetes Clinic, Soroka University Medical Center, P.O.B. 151, Beer Sheva 84101, Israel.
    Affiliations
    Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel

    Diabetes Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O.B. 635, Beer-Sheva 8410501, Israel
    Search for articles by this author
  • Author Footnotes
    1 Equal contribution.
Published:January 02, 2023DOI:https://doi.org/10.1016/j.pcd.2022.12.004

      Highlights

      • Retrospective cohort study of diabetes patients who underwent cataract surgery.
      • Probed association of glycemic control and pseudophakic cystoid macular edema-CME.
      • Main variables influencing risk for CME were diabetic retinopathy and HbA1c level.
      • High glycated hemoglobin level was independent risk factor for developing CME.
      • CME patients likelier younger, longer diabetes, type 1 diabetes, and retinopathic.

      Abstract

      Aims

      Cataract, the most common cause of blindness, has higher prevalence among patients with diabetes mellitus. About 20% of cataract surgeries are performed on patients with diabetes. One of the complications of cataract surgery is pseudophakic cystoid macular edema (CME). This study examined whether patients’ glycemic control (as indicated by HbA1c level before cataract surgery) is associated with CME incidence within one year post-surgery.

      Methods

      We conducted a retrospective cohort study of 1285 diabetes patients over age 18 who underwent cataract surgery between January 2015 and January 2020. Data were obtained from medical records reporting glycated hemoglobin (HbA1c) level prior to surgery and post-operative CME with intraocular anti-vascular endothelial growth factor injections.

      Results

      The patients with CME complications were younger, with longer duration diabetes, and higher percentages of type 1 diabetes and diabetic retinopathy. The main variables influencing risk of post-operative CME were found to be diabetic retinopathy and HbA1c level. Multivariate analysis revealed that HbA1c is an independent risk for post-operative CME with a relative risk of 2.01 when HBa1c is above 7 c (95% CI, 1.10–3.67).

      Conclusion

      The study demonstrates that pre-cataract surgery diabetes control, measured by HbA1c level, is an independent risk factor for developing post-surgery CME.

      Keywords

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