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Rapid preoperative glycemic control tied to higher complication rates after cataract surgery

Ophthalmology 360

Key Takeaways

  1. Rapid preoperative glycemic control was associated with higher rates of postoperative complications, particularly macular edema and vitreous hemorrhage.
  2. Rapid glycemic correction and more advanced diabetic retinopathy were the main risk factors for complications.
  3. Visual acuity improved significantly after surgery, and timely intervention for diabetic retinopathy was linked to fewer severe complications.

Rapid preoperative glycemic control in patients with type 2 diabetes and elevated HbA1c levels was associated with higher rates of postoperative complications following cataract surgery, according to a retrospective cohort study.

Researchers reviewed medical records from 152 patients (222 eyes) with HbA1c greater than 9.0% who underwent rapid glycemic control over an average of about 17 days, and 111 patients (162 eyes) with HbA1c below 7.0%. Outcomes were assessed over a 6-month postoperative period.

Macular edema and vitreous hemorrhage occurred in 11.7% of eyes in the rapid control group and 4.9% in the basic control group (P = 0.021). Rapid glycemic correction (P < 0.001) and moderate to severe non-proliferative diabetic retinopathy were identified as key risk factors for postoperative complications.

Among patients in the rapid control group who received timely intervention for diabetic retinopathy, only 3.8% developed severe complications (P = 0.019). No cases of endophthalmitis, hyphema, or incision leakage were reported in this group.

Despite the increased complication risk, visual outcomes improved significantly. Mean best-corrected visual acuity in the rapid control group improved from 1.26 ± 0.74 logMAR preoperatively to 0.30 ± 0.32 logMAR at final follow-up (P < 0.0001).

Reference

Wang Y, Wu X, Liu X, et al. Surgical Outcomes of Cataract Surgery Following Rapid Glycemic Control During Preoperative Period. Clin Ophthalmol. 2026;20:561071. doi: 10.2147/OPTH.S561071. PMID: 41847524; PMCID: PMC12990226.

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