Key takeaways:
- Posterior capsule rupture was additionally extra probably in these sufferers.
- Intracameral and topical antibiotic use lowered the chance for postoperative endophthalmitis.
Postoperative endophthalmitis after cataract surgical procedure is greater than 17% extra probably in sufferers with diabetes, whereas posterior capsule rupture throughout surgical procedure is greater than thrice as probably, in keeping with a assessment.
The info additionally linked considerably decrease postoperative endophthalmitis threat, with or with out diabetes, to using postoperative intracameral and topical antibiotics.
Information derived from Chen KY, et al. J Ophthalmic Inflamm Infect. 2025;doi:10.1186/s12348-025-00483-9.
Postoperative endophthalmitis is likely one of the most severe problems of cataract surgical procedure and “can result in extreme visible impairment and even blindness,” Kai-Yang Chen, of the Faculty of Medication at Taipei Medical College, Taiwan, and colleagues wrote within the Journal of Ophthalmic Irritation and An infection.
“Diabetes mellitus is a acknowledged threat issue for [postoperative endophthalmitis] on account of its affiliation with delayed wound therapeutic, heightened inflammatory responses and compromised immunity,” they stated. “Given the rising frequency of cataract surgical procedures on this inhabitants, a radical analysis of threat components and outcomes is essential to bettering perioperative care and decreasing problems.”
Chen and colleagues carried out a scientific assessment of 9 research with information on cataract surgical procedures in folks with diabetes, seven of which have been additionally included in a meta-analysis. They used random results fashions to calculate pooled odds ratios for postoperative endophthalmitis and posterior capsule rupture (PCR).
General, sufferers with diabetes present process cataract surgical procedure have been 17.4% extra prone to develop postoperative endophthalmitis (pooled OR = 1.174; 95% CI, 1.109-1.242) than these with out diabetes, with an incidence charge of 0.261% vs. 0.242%. PCR was greater than thrice as probably (pooled OR = 3.434; 95% CI, 1.789-6.591) in sufferers with diabetes.
“The elevated PCR threat in folks with diabetes could also be attributed to components equivalent to altered lens anatomy and the larger prevalence of comorbidities that complicate surgical procedure,” the researchers wrote. “Consequently, PCR in folks with diabetes could amplify the chance of [postoperative endophthalmitis], because the rupture creates a pathway for microbial entry, heightening the an infection threat.”
A pooled evaluation of three research revealed that using postoperative intracameral and topical antibiotics considerably decreased the chance for postoperative endophthalmitis, no matter diabetes standing (OR = 0.231; 95% CI, 0.134-0.399).
Particular person research additionally reported considerably elevated threat for postoperative endophthalmitis in sufferers with diabetes who have been males (OR = 1.634; P = .048) or had hypertension (OR = 3.961; P < .001).
“Our examine signifies that for folks with diabetes present process cataract surgical procedure, it’s essential to take care of well-controlled blood sugar and blood stress beforehand,” Chen and colleagues wrote. “Throughout surgical procedure, further warning ought to be taken to forestall PCR, and applicable antibiotic use ought to be thought of to reduce the chance of [postoperative endophthalmitis].”
