Cataract surgery-related complications in patients with end-stage renal disease- a nationwide population-based study in Taiwan

Abstract

this nationwide retrospective case-control study was aimed at elucidating the risk from cataract surgery in end-stage renal disease (ESRD) patients. Cataract surgery patients were identified using the diagnostic and procedural codes for International Classification of Diseases, 9 th Revision, Clinical Modification from Taiwan's National Health Insurance Research Database. ESRD patients were selected as cases, while propensity scores for age, sex, comorbidities and year-of-surgery-matched patients without chronic kidney disease constituted the controls. patients who had undergone eye surgery within 3 years before cataract surgery were excluded. The main outcome measures were target cataract surgery-related complications within 3 months after surgery. A total of 352 cases and 1,760 controls were analysed. Patients with ESRD had a 5.06-fold (95% CI: 2.36-10.87; p < 0.001) risk of vitreous haemorrhage and a 2.74-fold (95% CI: 1.20-6.27; p = 0.017) risk of re-operation for dropped nucleus or vitreous complications. Non-diabetic ESRD patients had a 3.49-fold (95% CI: 1.36-8.91; p = 0.009) risk of corneal oedema. In conclusion, ESRD patients have a higher risk of vitreous haemorrhage, reoperation for dropped nucleus or vitreous complications and corneal oedema (non-diabetic patients) after cataract surgery. Pre-surgery corneal examination, surgery procedure and medication adjustment, closer and longer post-surgery follow-up may lower the risk and improve the visual outcome.Cataract is the most common cause of blindness worldwide, and successful cataract surgery restores vision to most patients. Although cataract surgery is a minor procedure, complications sometimes develop that influence the visual outcome. In particular, cataract surgery can lead to glaucoma, vitreous haemorrhage (VH), retinal detachment, intraocular dislocation, dropped nucleus, and wound dehiscence 1 .Patients with end-stage renal disease (ESRD) were reported to have an increased risk of complications such as bleeding, infection and perioperative mortality when they received major inpatient surgeries 2-4 . ESRD patients were noted to have a higher risk of cataract 5 . Only a few studies have reported cataract surgery-related risk in ESRD patients 6,7 , and these studies involved only a small number of patients and no control group.The purpose of the present study was to elucidate the risk of cataract surgery-related complications in patients receiving dialysis and to compare this risk to those in patients without chronic kidney disease (CKD) or ESRD. As such, the study may inform better patient care and improve surgical outcomes.

Risk of head and neck cancer in patients with peptic ulcers and the effect of Helicobacter pylori treatment

“…The National Health Insurance (NHI) program is a single-payer, compulsory, universal health insurance plan established on March 1, 1995 that covers all forms of health care services for more than 99% of Taiwan’s 23.5 million residents 23 , 24 . The National Health Insurance Research Database (NHIRD) included comprehensive medical data, including records of registration, ambulatory and inpatient care, catastrophic illnesses, and drug prescriptions 23 – 27 . Patient identification numbers and other sensitive personal data have been encrypted in NHIRD to protect individual privacy 27 .…”

“…The National Health Insurance Research Database (NHIRD) included comprehensive medical data, including records of registration, ambulatory and inpatient care, catastrophic illnesses, and drug prescriptions 23 – 27 . Patient identification numbers and other sensitive personal data have been encrypted in NHIRD to protect individual privacy 27 . This study used data from the Longitudinal Health Insurance Database 2000 (LHID 2000), which is a subset of the NHIRD.…”

Hemodialysis Effect on the Composition of the Eye Fluid of Cataract Patients

“…Many reports have demonstrated that, for patients with end-stage renal disease (ESRD), the risk of cataract [ 2 ], as well as postoperative complications, is significantly higher [ 3 , 4 , 5 , 6 , 7 ]. The first retrospective case–control study that undertook a risk assessment of cataract surgery in patients with ESRD was reported in 2020 [ 8 ]. The study covered 352 cases and 1760 controls who underwent cataract-removal surgery between 2002 and 2013 in Taiwan.…”