Incidence of ocular pathology following bariatric surgery for with morbid obesity across a large United States National Database

Abstract

Background/Objectives Bariatric surgery, as indicated for treatment of morbid obesity, has been studied in association with short term effects on ocular pathology. However, effects of surgery on postoperative disease incidence is largely unknown. Subjects/Methods In this retrospective cohort study, the TriNetX United States Collaborative Network national database, was queried for patients with an ICD-10 code for morbid obesity and a procedural code for bariatric surgery. Patients were propensity score matched across baseline demographics at the time of surgery and compared to those presenting with an ICD10 code for morbid obesity with no records of a procedural code for bariatric surgery, identifying 42,408 patients per cohort. New diagnoses or procedural codes found after the surgical index date for diabetic retinopathy, age-related macular degeneration, glaucoma, low vision, and blindness along with pertinent treatment metrics were monitored. Results Bariatric surgery was found to be associated with reduced future risk of diabetic retinopathy (RR: 0.283; 95% CI: 0.252–0.319), macular edema (RR: 0.224; 95% CI: 0.170–0.297), vitreous hemorrhage (RR: 0.459; 95% CI: 0.323–0.653), ocular hypertension (RR: 0.387; 95% CI: 0.387–0.487), glaucoma (RR: 0.360; 95% CI: 0.326–0.399), use of ocular pressure lowering medications (RR: 0.565; 95% CI: 0.496–0.644), age-related macular degeneration (RR: 0.628; 95% CI: 0.447–0.882), cataract surgery (RR: 0.524; 95% CI: 0.448–0.612), and low vision and blindness (RR: 0.328; 95% CI: 0.294–0.365) compared to patients not surgically managed. Conclusions The present analysis comprising a large US cohort of patients suggests that bariatric surgery is associated with a decreased risk of future ocular morbidity and mortality.