Predisposing Factors for Severe Complications after Cataract Surgery: A Nationwide Population-Based Study

Abstract

We conducted a retrospective group study to evaluate the potential systemic risk factors for major postoperative complications of cataract surgery. Individuals diagnosed with (n = 2046) and without (n = 8184) serious complications after cataract surgery were matched 1:4 for age, sex, and index date obtained using Taiwan’s National Health Insurance Research Database. The outcome was defined as at least one new inpatient or outpatient diagnosis of systemic disease one year before the index date. The effect of demographic data on postoperative complications was also analyzed in the multivariable model. Data were analyzed using univariate and multivariate conditional logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals of the risk of developing serious complications. After the entire study interval, the major postoperative complications of cataract surgery were associated with the following systemic diseases: hypertension (adjusted OR (aOR) = 2.329, p < 0.001), diabetes mellitus (aOR = 2.818, p < 0.001), hyperlipidemia (aOR = 1.702, p < 0.001), congestive heart failure (aOR = 2.891, p < 0.001), rheumatic disease (aOR = 1.965, p < 0.001), and kidney disease needing hemodialysis (aOR = 2.942, p < 0.001). Additionally, demographic data including old age, higher urbanization level, higher level of care, and more frequent inpatient department visits were associated with a higher rate of postoperative complications. In conclusion, metabolic syndrome, chronic heart failure, end-stage renal disease, rheumatic disease, older age, and frequent inpatient department visits are correlated with the development of severe postoperative complications of cataract surgery. Therefore, cataract surgery patients should be informed about a higher possibility of postoperative complications.

Comparative Study of Safety Outcomes Following Nucleus Disassembly with and without the miLOOP Lens Fragmentation Device During Cataract Surgery

“…A larger cohort size suitable to perform pre-planned subgroup analyses with respect to subject age, gender, and additional comorbidities could make study findings generalizable to more diverse patient populations. 24 The current study findings support prior observations that device-assisted lens prefragmentation is a safe method to facilitate the treatment of advanced dense cataracts, and the associated reduction in ultrasound energy required for phacoemulsification of the pre-segmented nucleus might have protective benefits for delicate intraocular structures. The prefragmentation device can be operated with one hand, has an uncomplicated learning curve, and might improve operational efficiency and patient outcomes.…”

Analyzing the changing trend of corneal biomechanical properties under different influencing factors in T2DM patients

“…The main manifestations of these patients are decreased corneal sensation, delayed corneal epithelial regeneration, and bullous corneal endothelial disease, which is followed by severe lesions, such as persistent corneal epithelial erosion, superficial punctate keratopathy, and even corneal ulcers 11 – 13 . It is potentially a vision-threatening disease that can lead to decreased vision or permanent visual loss, especially after undergoing treatments such as phacoemulsification and vitrectomy 14 – 16 . Some scholars believe that long-term elevations in blood sugar levels may lead to impaired endothelial "pump" function before intraocular surgery 17 .…”

Analyzing the changing trend of corneal biomechanical properties under different influencing factors in T2DM patients

“…The main manifestations of patients are decreased corneal perception, delayed corneal epithelial regeneration, and bullous corneal endothelial disease, which is followed by severe lesions such as persistent corneal epithelial erosion, shallow punctate keratopathy, and even corneal ulcers. It is a potential visual threatening disease that can lead to decreased vision or permanent visual loss, especially after undergoing treatment such as cataract phacoemulsi cation and vitrectomy [11][12][13] . Some scholars believed that long-term elevated blood sugar levels may lead to impaired endothelial "pump" function before intraocular surgery [14] .…”