Cataract surgery is associated with increased incidence of diabetic retinopathy among patients with diabetes

1. Cataract surgery in patients with diabetes is associated with a significantly increased incidence of diabetic retinopathy (DR). 

Evidence Rating Level: 2 (Good)

DR is a significant cause of blindness among adults and is highly prevalent among patients with diabetes worldwide. Alongside DR, cataracts are another ophthalmologic pathology frequently seen in this patient population. However, the association between cataract surgery and the risk of developing DR and progression of existing DR remain controversial. This retrospective cohort study therefore sought to investigate the association between cataract surgery and the development and progression of DR. 31,206 patients from Taiwan with a history of diabetes and cataracts between 2010 and 2021 were included in the study. Patients who underwent cataract surgery were further matched in two stages, with a 1:2 matching based on age and sex and 1:1 propensity score matching. Among patients who underwent cataract surgery, the progression rate of DR was approximately 2% and 3% at 6 months and 1 year, respectively, compared to approximately 0.5% and 1% at 6 months and 1 year in the comparison group (p < 0.05). Patients who underwent cataract surgery also had a significantly increased incidence of DR within 1 year compared to the comparison group, (adjusted odds ratio, 3.40 [95% CI, 2.65-4.36] and 3.03 [95% CI, 2.26-4.06] for the 1:2 age- and sex matched and 1:1 propensity score-matched groups, p < 0.001). Overall, this study found that among patients with diabetes who underwent cataract surgery, the risk of DR incidence and progression was increased compared to those who did not undergo cataract surgery. 

Click here to read this study in BMJ Open

Image: PD

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