Dose-Response Risk Of Diabetes Mellitus For Endophthalmitis After Cataract Surgery In A Nationwide Cohort Study In Taiwan
Published 2024 - 42nd Congress of the ESCRS
Reference: PO365 | Type: Free paper | DOI: 10.82333/90xw-tp52
Authors: Chiunho Hou* 1 , Jiahn-Shing Lee 2 , Ken-Kuo Lin 2
1Ophthalmology,National Taiwan University Hospital,Taipei,Taiwan, Province of China, 2Ophthalmology,Chang Gung Memorial Hospital, Linkou,Taoyuan,Taiwan, Province of China
Purpose
To investigate the dose-response risk of endophthalmitis after cataract surgery in patients with diabetes mellitus (DM).
Setting
A nationwide retrospective cohort study.
Methods
Patients who underwent bilateral cataract surgeries between the years 2000 and 2017 were included in this study, utilizing the Taiwan National Health Insurance Research Database. A comparative analysis of endophthalmitis incidence within three months post-cataract surgery was conducted between cohorts with and without diabetes mellitus (DM) employing a generalized estimating equation (GEE). Additionally, the diabetes complications severity index (DSCI) score was employed to evaluate the dose-response relationship with respect to the endophthalmitis rate.
Results
A total of 883,398 patients (1,766,796 eyes) were included. Patients with DM had a higher risk of post-cataract surgery endophthalmitis compared to those without DM (0.261% vs. 0.242%, adjusted odds ratio = 1.09, 95% CI = 1.03–1.16). This elevated risk persisted after excluding those with prior vitrectomy or intravitreal injection (IVI) and receiving IVI between cataract surgery and endophthalmitis (p = 0.0156, 0.0048, and 0.0139). A significant dose–response relationship was observed in DM patients with a DCSI score >10. Among DM complications, patients with metabolic disorders had the highest endophthalmitis rate (0.342%).
Conclusions
DM emerged as a discernible risk factor for post-cataract surgery endophthalmitis, even after adjustments for age, sex, common systemic disorders, and the exclusion of individuals with a history of vitrectomy or IVI, as well as those who received IVI between cataract surgery and the onset of endophthalmitis. Furthermore, a distinct dose-response relationship was identified in DM patients with a DCSI score surpassing 10.