Intraoperative Complications and Visual Outcomes of Cataract Surgery in Diabetes Mellitus: A Multicenter Database Study

Chancellor, John R.; Soliman, Mohamed Kamel; Shoults, Catherine C.; Faramawi, Mohammed F.; Al-Hindi, Hytham; Kirkland, Kyle A.; Chu, Colin J; Yang, Ya-Ting; Sallam, Ahmed

doi:10.1016/j.ajo.2020.12.027

Cited by 22 publications

(19 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous smaller studies also reported a significant association between PCR and white cataract, small pupil, and pseudoexfoliation, and diabetic retinopathy. 2,3,21 It has been proposed that diabetic retinopathy may increase the risk of PCR due to a more rigid pupil, advanced cataract, or previous intravitreal injections. 2,21 Chancellor et al described an incidence of PCR of 2.3% in patients with diabetic retinopathy compared to 1.6% in patients without diabetic retinopathy.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery

Segers

Behndig

Biggelaar

et al. 2022

J Cataract Refract Surg

View full text Add to dashboard Cite

PURPOSE: To analyze the incidence and risk factors of posterior capsule rupture (PCR) in cataract surgery. SETTING: European clinics affiliated with the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). DESIGN: Retrospective cross-sectional register-based study. METHODS: Data was obtained from the EUREQUO. The database contains data on demographics, comorbidities, and intraoperative complications, including PCR for the study period from January 1, 2008, to December 31, 2018. Univariablte and multivariablte logistic regression analyses were performed to estimate the (adjusted) odds ratio (OR) and 95% confidence intervals (CI).RESULTS: Data was available of 2,853,376 patients and 31,749 (1.1%) cataract surgeries were complicated by a PCR. The PCR rate ranged from 0.60 to 1.65 percent throughout the years, with a decreasing trend (p <0.001). The mean age of the PCR cohort was 74.8 ± 10.5 years and 17,629 (55.5%) patients were female. Risk factors most significantly associated with PCR were corneal opacities (OR 3.21, 95% CI 3.02 -3.41, p <0.001), diabetic retinopathy (OR 2.74, 95% CI 2.59 -2.90, p <0.001), poor preoperative visual acuity (OR 1.98, 95% CI 1.88 -2.07, p <0.001), and white cataract (OR 1.87, 95% CI 1.72 -2.03, p <0.001).CONCLUSION: Risk factors for PCR were identified based on the EUREQUO and the incidence of this complication is decreasing over time.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery

Segers

Behndig

Biggelaar

et al. 2022

J Cataract Refract Surg

View full text Add to dashboard Cite

show abstract

“…A recent multicenter study on 179,159 eyes found higher rates of posterior capsule rupture and dropped nuclear fragments in diabetic patients undergoing phacoemulsification surgery compared to non-diabetics. 13 Rate of posterior capsule rupture was 2.1% in the diabetic group compared to 1.6% in non-diabetics. 0.3% of diabetic patients had dropped nuclear fragments, compared to 0.2% of non-diabetics.…”

Section: Discussionmentioning

confidence: 82%

“…0.3% of diabetic patients had dropped nuclear fragments, compared to 0.2% of non-diabetics. 13 Diabetes (with or without retinopathy) was found to be a risk factor for posterior capsule rupture with an OR of 1.263. It was proposed that diabetes may increase the rate of posterior capsule rupture owing to increased surgical complexity from poor pupillary dilation, denser cataract, or prior vitrectomy.…”

Section: Discussionmentioning

confidence: 96%

“…It was proposed that diabetes may increase the rate of posterior capsule rupture owing to increased surgical complexity from poor pupillary dilation, denser cataract, or prior vitrectomy. 13 While the Buckinghamshire system included diabetic retinopathy as one of the preoperative risk factors, neither they nor the Muhtaseb system had diabetic status as a preoperative risk factor. A future analysis comparing the relationship of HbA1c and rates of intra and postoperative complications would be interesting.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, based on the trends in our study, as well as results from the recent multicenter study, we will be adding diabetic status to our risk stratification system in the future. 13 …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of Preoperative Risk Stratification on Resident Phacoemulsification Surgeries

Moussa¹,

Frank²,

Valenzuela³

et al. 2022

OPTH

View full text Add to dashboard Cite

Purpose To evaluate efficacy of a novel risk stratification system in minimizing resident surgical complications and to evaluate whether the system could be used to safely introduce cataract surgery to earlier levels of training. Materials and Methods This is a retrospective cross-sectional study on 530 non-consecutive cataract cases performed by residents at Columbia University. Risk scores, preoperative best corrected visual acuity (BCVA), intraoperative complications, postoperative day 1 (POD1), and month 1 (POM1) exam findings were tabulated. The relationship between risk scores and POD1 and POM1 BCVA was modeled using linear regression. The relationship between risk scores and complication rates was modeled using logistic regression. Logistic regression was used to model the rates of complications across different levels of training. Rates of complications were compared between diabetic versus non-diabetic patients using t-tests. Results Risk scores did not have significant association with intraoperative complications. Risk scores were predictive of corneal edema (OR = 1.36, p = 0.0032) and having any POM1 complication (OR = 1.20, p = 0.034). Risk scores were predictive of POD1 ( β = 0.13, p < 0.0001) and POM1 ( β = 0.057, p = 0.00048) visual acuity. There was no significant association between level of training and rates of intraoperative (p = 0.9) or postoperative complications (p = 0.06). Rates of intraoperative complication trended higher among diabetic patients but was not statistically significant (p = 0.2). Conclusion Higher risk scores were predictive of prolonged corneal edema but not risk of intraoperative complications. Our risk stratification system allowed us to safely introduce earlier phacoemulsification surgery.

show abstract

Retinal thickness changes due to phacoemulsification in patients with diabetes

Leisser,

Kanclerz,

Ruiss

et al. 2024

Spektrum Augenheilkd.

View full text Add to dashboard Cite

Intraoperative Complications and Visual Outcomes of Cataract Surgery in Diabetes Mellitus: A Multicenter Database Study

Cited by 22 publications

References 18 publications

Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery

Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery

Efficacy of Preoperative Risk Stratification on Resident Phacoemulsification Surgeries

Retinal thickness changes due to phacoemulsification in patients with diabetes

Contact Info

Product

Resources

About