The Influence of Diabetes Status on the Rate of Cataract Surgery Following Pars Plana Vitrectomy

Mohammed F Faramawi; Leanna M Delhey; John R Chancellor; Ahmed B Sallam

doi:10.1016/j.oret.2019.09.011

The Influence of Diabetes Status on the Rate of Cataract Surgery Following Pars Plana Vitrectomy

Ophthalmol Retina. 2020 May;4(5):486-493. doi: 10.1016/j.oret.2019.09.011. Epub 2019 Sep 28.

Authors

Mohammed F Faramawi¹, Leanna M Delhey¹, John R Chancellor², Ahmed B Sallam³

Affiliations

¹ Epidemiology Department, College of Public Health and Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
² Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
³ Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address: ahmedsallam11@yahoo.com.

PMID: 31786136
DOI: 10.1016/j.oret.2019.09.011

Abstract

Purpose: We aimed to evaluate the association between diabetic status and the rates of cataract extraction (CE) following pars plana vitrectomy (PPV).

Design: Retrospective cohort, multicenter database study.

Participants: Patients were selected from an insurance claims database (PharMetrics LifeLink) that included persons who had filed claims between 2006 and 2015 in the United States.

Methods: We analyzed the records of 22 146 patients who underwent PPV performed by 2705 retina physicians. The vitrectomy group included patients ≥18 years of age who had undergone PPV. The control group included patients who were matched to the vitrectomy group 1:2 based on sex, diabetes mellitus (DM) status, region of the United States, and Charleston Comorbidity Index.

Main outcome measures: Hazard ratios (HRs) and rates of cataract surgery in patients with and without diabetes who had undergone prior PPV.

Results: The hazard ratio for post-PPV CE was lower among patients with diabetes (3.307; 95% confidence interval [CI], 3.051-3.583) than among patients without diabetes (4.889; 95% CI, 4.670-5.119). This association was significant for all subgroups of patients with diabetes except in patients with diabetes and without retinopathy (4.086; 95% CI, 3.511-4.754). There was a significantly longer time between PPV and CE in patients with diabetes (537 days; 95% CI, 459-677 days) compared with those without diabetes (295 days; 95% CI, 278-312 days). The type of DM (type 1 vs. type 2) did not influence the rate of post-PPV cataract surgery. In persons with diabetes who underwent PPV, we observed a trend for a lower HR of cataract surgery in eyes with proliferative retinopathy (0.903; 95% CI, 0.725-1.124), and nonproliferative retinopathy (0.965; 95% CI, 0.721-1.290) compared with eyes with no retinopathy.

Conclusions: Eyes of patients with diabetes had a significantly decreased risk of undergoing CE after PPV surgery compared with eyes of patients without diabetes.

Publication types

Multicenter Study

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Cataract / complications*
Cataract Extraction*
Diabetic Retinopathy / complications
Diabetic Retinopathy / diagnosis
Diabetic Retinopathy / surgery*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Visual Acuity*
Vitrectomy / methods*
Young Adult