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The Association Between Glycaemic Control, Renal Function and Post-operative Ophthalmic Complications in People With Diabetes Undergoing Cataract Surgery—A Single-Centre Retrospective Analysis
INTRODUCTION: In general surgery, it has been shown that poor peri-operative diabetes control, as measured by glycated haemoglobin (HbA(1c)), is associated with adverse post-operative outcomes. National data for the UK suggest that the post-operative complication rate for cataract surgery is 2.8%. I...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8991233/ https://www.ncbi.nlm.nih.gov/pubmed/35278194 http://dx.doi.org/10.1007/s13300-022-01241-z |
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author | Boroojeny, Ayda Borjian Nunney, Ian Dhatariya, Ketan K. |
author_facet | Boroojeny, Ayda Borjian Nunney, Ian Dhatariya, Ketan K. |
author_sort | Boroojeny, Ayda Borjian |
collection | PubMed |
description | INTRODUCTION: In general surgery, it has been shown that poor peri-operative diabetes control, as measured by glycated haemoglobin (HbA(1c)), is associated with adverse post-operative outcomes. National data for the UK suggest that the post-operative complication rate for cataract surgery is 2.8%. It is unknown whether people with diabetes who undergo cataract surgery are also at increased risk. METHODS: This single-centre retrospective study looked at the association of peri-operative HbA(1c) and estimated glomerular filtration rate (eGFR) with the risk of post-operative complications in people undergoing phacoemulsification and intraocular lens implantation under local anaesthesia during 2016. RESULTS: 4401 individuals had cataract surgery. Of these, 34.6% (1525) had diabetes. Of those with diabetes, 114 (7.5%) developed a post-operative ophthalmological complication (as defined by the Royal College of Ophthalmologists) necessitating at least one eye clinic appointment. Mean HbA(1c) did not differ between those who did and those who did not develop complications (52 vs 50 mmol/mol, p = 0.12). After adjustment, HbA(1c) was not a significant risk (OR 1.00; 95% CI: 0.99–1.05; p = 0.85). However, eGFR had a small but statistically significant effect on outcome (OR 0.99; 95% CI: 0.98–1.00; p = 0.02). CONCLUSIONS: This study has shown that more people who undergo cataract surgery have diabetes than previously reported. Also, people with diabetes are at higher risk of developing complications than previously reported. HbA(1c) concentration was not a factor in these adverse post-operative outcomes. However, eGFR was a predictor of risk. More focus should be placed on pre-operatively optimising co-morbidities than diabetes control in those undergoing cataract surgery. |
format | Online Article Text |
id | pubmed-8991233 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-89912332022-04-22 The Association Between Glycaemic Control, Renal Function and Post-operative Ophthalmic Complications in People With Diabetes Undergoing Cataract Surgery—A Single-Centre Retrospective Analysis Boroojeny, Ayda Borjian Nunney, Ian Dhatariya, Ketan K. Diabetes Ther Original Research INTRODUCTION: In general surgery, it has been shown that poor peri-operative diabetes control, as measured by glycated haemoglobin (HbA(1c)), is associated with adverse post-operative outcomes. National data for the UK suggest that the post-operative complication rate for cataract surgery is 2.8%. It is unknown whether people with diabetes who undergo cataract surgery are also at increased risk. METHODS: This single-centre retrospective study looked at the association of peri-operative HbA(1c) and estimated glomerular filtration rate (eGFR) with the risk of post-operative complications in people undergoing phacoemulsification and intraocular lens implantation under local anaesthesia during 2016. RESULTS: 4401 individuals had cataract surgery. Of these, 34.6% (1525) had diabetes. Of those with diabetes, 114 (7.5%) developed a post-operative ophthalmological complication (as defined by the Royal College of Ophthalmologists) necessitating at least one eye clinic appointment. Mean HbA(1c) did not differ between those who did and those who did not develop complications (52 vs 50 mmol/mol, p = 0.12). After adjustment, HbA(1c) was not a significant risk (OR 1.00; 95% CI: 0.99–1.05; p = 0.85). However, eGFR had a small but statistically significant effect on outcome (OR 0.99; 95% CI: 0.98–1.00; p = 0.02). CONCLUSIONS: This study has shown that more people who undergo cataract surgery have diabetes than previously reported. Also, people with diabetes are at higher risk of developing complications than previously reported. HbA(1c) concentration was not a factor in these adverse post-operative outcomes. However, eGFR was a predictor of risk. More focus should be placed on pre-operatively optimising co-morbidities than diabetes control in those undergoing cataract surgery. Springer Healthcare 2022-03-12 2022-04 /pmc/articles/PMC8991233/ /pubmed/35278194 http://dx.doi.org/10.1007/s13300-022-01241-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Boroojeny, Ayda Borjian Nunney, Ian Dhatariya, Ketan K. The Association Between Glycaemic Control, Renal Function and Post-operative Ophthalmic Complications in People With Diabetes Undergoing Cataract Surgery—A Single-Centre Retrospective Analysis |
title | The Association Between Glycaemic Control, Renal Function and Post-operative Ophthalmic Complications in People With Diabetes Undergoing Cataract Surgery—A Single-Centre Retrospective Analysis |
title_full | The Association Between Glycaemic Control, Renal Function and Post-operative Ophthalmic Complications in People With Diabetes Undergoing Cataract Surgery—A Single-Centre Retrospective Analysis |
title_fullStr | The Association Between Glycaemic Control, Renal Function and Post-operative Ophthalmic Complications in People With Diabetes Undergoing Cataract Surgery—A Single-Centre Retrospective Analysis |
title_full_unstemmed | The Association Between Glycaemic Control, Renal Function and Post-operative Ophthalmic Complications in People With Diabetes Undergoing Cataract Surgery—A Single-Centre Retrospective Analysis |
title_short | The Association Between Glycaemic Control, Renal Function and Post-operative Ophthalmic Complications in People With Diabetes Undergoing Cataract Surgery—A Single-Centre Retrospective Analysis |
title_sort | association between glycaemic control, renal function and post-operative ophthalmic complications in people with diabetes undergoing cataract surgery—a single-centre retrospective analysis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8991233/ https://www.ncbi.nlm.nih.gov/pubmed/35278194 http://dx.doi.org/10.1007/s13300-022-01241-z |
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