Abstract
Purpose:
An ongoing quality improvement study is being performed in the Ophthalmology department at Boston Medical Center (BMC) to identify factors affecting refractive outcomes in cataract surgery (CE) in order to reduce refractive surprise. Numerous technical factors have been identified as predictors of refractive surprise, but patient factors have not been fully explored. The goal of this abstract is to determine if diabetes mellitus (DM) had any effect on refractive outcomes in CE.
Methods:
Retrospective chart review of all CE at BMC between July 1, 2013 to June 30, 2014. Inclusion criteria include all CE in patients over the age of 18. Exclusion criteria include patients with no recorded postoperative refraction within 90 days. Two-tailed t-tests and z-tests were used to compared DM and nonDM patients.
Results:
817 total patients underwent CE. 69 patients were excluded. 253 patients had a history of DM. DM patients:<br /> Postoperative spherical equivalent (SE): 156 patients had +/- 0.5 or better SE, 69 had between +/- >0.5 to 1.00, 28 had > +/- 1.00. NonDM patients: Postoperative SE: 259 patients had S.E. of +/- 0.5 or better, 148 had between +/- >0.5 to 1.00, 88 had > +/- 1.00. Comparing the two groups, significantly more patients with DM had a SE +/- 0.5 or less postoperatively (p=0.015). The two groups did not differ significantly for outcomes of SE between +/- 0.5 to 1.00 (p=0.45). More nonDM patients had > +/-1.00 SE postoperatively (p=0.016).
Conclusions:
Patients with DM had better refractive outcomes after CE when compared to patients without DM in our study. DM patients also had less large refractive surprises (SE > +/- 1.00). Numerous confounding variables may play a role in this finding, and further investigations may explore this relationship.