The Risk of Posterior Capsule Rupture in Patients with Type 2 Diabetes Mellitus and Diabetic Retinopathy During Phacoemulsification Cataract Surgery

Abstract

Purpose : To determine whether type 2 diabetes mellitus (T2DM) with and without diabetic retinopathy (DR) are independent risk factors for PCR during cataract surgery while accounting for previous intravitreal injections (IVI).

Methods : A retrospective study was conducted at the Sue Anschutz-Rodgers UCHealth Eye Center from January 2014 to March 2019. The primary outcome was incidence of PCR during phacoemulsification surgery in patients with T2DM with and without DR, accounting for previous IVI. Univariate and multivariable analysis were utilized to calculate odds ratios (OR) and adjusted odds ratios (AOR).

Results : A total of 10,893 eyes were included. A PCR occurred in 59 (0.5%) of eyes overall: 35 (0.4%) eyes in patients without diabetes, comparatively to 13 (0.7%) eyes with T2DM without DR (p=0.142), and 11 (1.8%) eyes with DR (p<0.0001).

All groups with previous IVI demonstrated a significant increase in PCR compared to eyes without IVI or T2DM. In the absence of IVI, T2DM without DR was not significant (p=0.520), but T2DM with DR had a significantly increased risk of PCR in univariate analysis (OR 3.55, 95% CI: 1.49,8.50, p=0.004) and an increased risk of borderline significance in multivariate analysis (AOR 2.33, 95% CI: 0.98, 5.56, p=0.056).

Conclusions : In the absence of IVI, T2DM without DR is not an independent risk factor for PCR. T2DM with DR is likely a risk factor but was of borderline significance due to small sample size. Previous IVI is an independent risk factor for PCR. Consideration of PCR risk should be given during surgical planning for patients with DR and/or previous IVI.

This is a 2021 ARVO Annual Meeting abstract.