Does Diabetic Status Influence the Rate of Cataract Surgery Following Pars Plana Vitrectomy Surgery?

The presence of diabetes mellitus is correlated with a lower rate of cataract extraction following par plana vitrectomy surgery (PPV), according to a study presented the 37^th ASRS Annual Meeting by Dr. Ahmed Sallam, MD PhD FRCOphth, University of Arkansas for Medical Sciences.

In this case control study, researchers assessed 4,825 eyes that underwent PPV surgery and 9,650 without PPV. Of that total, the number of diabetic eyes comprised 1,657 (34.34%) in the former group and 3,314 (34.34%) in the latter group, respectively. The researchers identified these participants using a 10% sample data from The LifeLink Database for claims of commercially insured population within the US between 2006 and 2015. Data were separated based of whether patients had PPV surgery or not. In the PPV arm, the study focused on only patients who underwent vitrectomy and excluded patients who had bilateral PPV, and those who did not have at least four months of continuous enrollment in the study. Subsequently, the researchers selected individuals from those eligible who had not had a PPV surgery using two non-PPV and one matching PPV matching, with matching performed based on age, gender, diabetes and geographic location. Cox-proportional hazards regression was used to ascertain hazard ratio (HR) for cataract extraction.

According to the results, following PPV surgery, 1,576 (32.66%) subjects underwent cataract surgery, compared to 458 (4.75%) (P<0.0001) cataract surgeries performed in the non-PPV group. The study found that age and sex adjusted hazard ratio for cataract surgery was 4.502 (95% CI, 4.291 to 4.723) juxtaposed with eyes requiring no vitrectomy. Moreover, among diabetic eyes, the results showed HR was 3.497 (HR=3.497; 95% CI, 3.205 to 3.816), compared to a reference group of diabetic non vitrectomized eyes. Furthermore, in non-diabetics, the ratio showed (HR=5.193; 95% CI, 4.894 to 5.509), compared to a reference group of non-diabetic, non-vitrectomized eyes. Overall, the researchers observed a trend for decreased HR in eyes with proliferative retinopathy (0.870, 95% CI, 0.682 to 1.110), and non-proliferative retinopathy (0.953, 95% CI = 0.69 to 1.314).

In conclusion, the authors noted that this large study confirms that diabetes is linked with a lower rate of cataract extraction and wrote that their findings “may have implications when planning vitrectomy surgery in phakic diabetic patients.”

Read more at: https://meeting2019.asrs.org/ondemand#/ondemand/papers/does-diabetic-status-influence-the-rate-of-cataract-surgery-following-pars–644

Sallam A. Does Diabetic Status Influence the Rate of Cataract Surgery Following Pars Plana Vitrectomy Surgery?  Presented at the 37^th ASRS Annual Meeting; July 26-30, 2019; Chicago, IL.