A recent study has highlighted that patients with diabetes undergoing cataract surgery face a significantly higher risk of complications, including postoperative endophthalmitis and posterior capsule rupture (PCR).
The review, published in the Journal of Ophthalmic Inflammation and Infection, found that patients with diabetes are 17% more likely to develop endophthalmitis, a severe eye infection that can lead to vision impairment or blindness. Additionally, these patients were found to be more than three times as likely to experience posterior capsule rupture, a critical complication during surgery.
Dr. Kai-Yang Chen, of the School of Medicine at Taipei Medical University, and colleagues pointed out that diabetes mellitus is a well-known risk factor for postoperative endophthalmitis. This is due to its effect on delayed wound healing, increased inflammatory responses, and compromised immunity. With the growing number of cataract surgeries performed on diabetic patients, the researchers emphasized the need for better risk management and preoperative care to reduce complications.
The study, which analyzed nine research studies, found that the rate of postoperative endophthalmitis in diabetic patients was 0.261%, compared to 0.242% in non-diabetic patients. The likelihood of PCR was also higher in diabetic patients, with a pooled odds ratio (OR) of 3.434, indicating that these patients are over three times more likely to experience a rupture of the posterior capsule during surgery.
The researchers also noted that diabetes-related changes in lens anatomy and the presence of comorbidities may complicate surgery, making it harder to avoid complications like PCR. The rupture itself can create a pathway for infection, further increasing the risk of endophthalmitis.
In positive news, the study found that the use of postoperative intracameral and topical antibiotics significantly reduced the risk of endophthalmitis, regardless of whether the patient had diabetes. This approach showed a reduction in risk by more than 75% (pooled OR = 0.231).
The study also highlighted additional risk factors, including gender and hypertension. Diabetic male patients had a 64% higher risk of developing endophthalmitis, and those with hypertension faced a fourfold increase in risk.
Given these findings, the researchers recommend that diabetic patients undergoing cataract surgery should ensure well-controlled blood sugar and blood pressure prior to surgery. Surgeons should also exercise extra caution during the procedure to prevent posterior capsule rupture and consider using antibiotics to minimize the risk of infection.
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