Nonproliferative may progress to proliferative diabetic retinopathy after cataract surgery

Patients with type 2 diabetes (T2D) and nonproliferative diabetic retinopathy (NPDR) who undergo modern cataract surgery tend to progress to proliferative diabetic retinopathy (PDR) within a year after the procedure, reveals a recent study.

In total, 7,178 patients for the right eye analysis and 7,232 for the left eye analysis were included in this retrospective study following propensity score matching. The researchers performed analyses by eye, calculating hazard ratios (HRs) with 95 percent confidence intervals (CIs) and performing a sensitivity analysis to examine patients with at least 5 years of T2D prior to cataract surgery.

In the right eye analysis, 1-year risks increased for PDR without complications (HR, 1.45, 95 percent CI, 1.09‒1.92), vitreous haemorrhage (VH; HR, 1.92, 95 percent CI, 1.13‒3.25), and the composite outcome (HR, 1.49, 95 percent CI, 1.13‒1.96) in operated eyes.

The left eye analysis also revealed elevated risks at 1 year for PDR without complications (HR, 1.58, 95 percent CI, 1.17‒2.13), VH (HR, 2.12, 95 percent CI, 1.23‒3.66), and the composite outcome (HR, 1.60, 95 percent CI, 1.21‒2.13) in operated eyes.

Some 4,976 patients with at least 5 years of T2D were included in the sensitivity analysis. At 1 year, risks increased for PDR without complications (HR, 1.52, 95 percent CI, 1.06‒2.19), VH (HR, 2.50, 95 percent CI, 1.20‒5.20), and the composite outcome (HR, 1.75, 95 percent CI, 1.22‒2.51) after surgery.

No significant difference was observed in the risk for tractional retinal detachment or combined tractional and rhegmatogenous retinal detachment in all analyses (p>0.05 for all).