Change in Hemoglobin A1c Levels After Cataract Surgery.

Abstract

Purpose : Impaired visual function may contribute to suboptimal glycemic control in diabetes mellitus. However, since prior studies examining changes in hemoglobin A1c (HbA1c) after cataract surgery have shown mixed results, it is unclear whether visual dysfunction from a clinically significant cataract affects glycemic control. We performed a retrospective, observational study to evaluate whether HbA1c levels change after cataract surgery.

Methods : As a pilot study we evaluated HbA1c in all patients who underwent cataract surgery at our institution in 2019 with HbA1c levels drawn both 0-90 days prior to and 90-180 days after cataract surgery. The primary outcome measure was the difference in HbA1c before and after cataract surgery for all study subjects. We performed subgroup analysis by age, based on the average, and in those with a pre-operative HbA1c ≥ 8. The pre-operative HbA1c cut off ≥ 8 was selected before analysis of data. HbA1c levels before and after cataract surgery were compared using a paired, two-tailed t-test in SPSS. We then expanded this study to include all patients who underwent cataract surgery from 2015-2019 with the same inclusion criteria as the pilot study in addition to HbA1c levels 690-780 days after surgery, if available.

Results : In the pilot study the mean and median ages of 102 study subjects was 71 years. There were 97 males and 5 females. Pairwise comparison of pre- versus post-operative HbA1c showed significantly lower post-operative HbA1c, with more reduction in older subjects and those with higher pre-operative HbA1c (Table 1). In the expanded study the mean and median ages of 436 subjects were 71.8 and 71 years, respectively. There were 424 males and 12 females. Pairwise comparison of pre- versus post-operative HbA1c showed a trend toward HbA1c reduction at 90-180 days, with a significant reduction in older subjects and those with higher pre-operative HbA1c, and this effect was sustained 690-780 days after surgery (Table 2).

Conclusions : Glycemic control improved after cataract surgery, with more improvement in older subjects and subjects with higher pre-operative HbA1c values.

This is a 2021 ARVO Annual Meeting abstract.

 

Table 1. Pilot study pre- & post-operative HbA1c values for all subjects, subjects with pre-operative HbA1c ≥ 8, older (≥ 71 years), and younger (< 71 years) subjects.

 

Table 2. Expanded study pre- & post-operative HbA1c values for all subjects, subjects with pre-operative HbA1c ≥ 8, older (≥ 71 years), and younger (< 71 years) subjects.