Glycaemic Control And Complications In Cataract Surgery - A Retrospective Audit

The link between poor glycaemic control and postoperative complications has not been fully established with respects to cataract surgery. This audit aimed to increase the evidence base and look at the levels of postoperative complications in patients with poorly controlled Diabetes mellitus (DM) who underwent cataract surgery.

This audit took place with data from Moorfields Eye Hospital in London.

An automated search of the OpenEyes EMR database was completed. Using patient ID’s pooled from this search, a comprehensive search was undertaken using OpenEyes and data was collected for various parameters. Following exclusion, a total of 145 eyes were identified having had cataract surgery between January 2023 - March 2024.

Average HbA1c was 87.7 mmol/mol with average BM being 14.7 mmols/L. 28 operations were cancelled and rescheduled, with poor diabetic control being the cause for approx. 36% of cancellations. There were no systemic or perioperative complications. 27% of patients had intraoperative/postoperative complications with the most common postoperative complication being CMO. The average HbA1c was 6.2 mmol/mol higher in those with postoperative complications compared to those with no complications. There were no cases of endophthalmitis.

Our results show that there is an association between poor glycaemic control and ophthalmic complications, however, this may very well be due to surgical complexity. No systemic complications/endophthalmitis were seen and therefore cancelling surgery on the grounds of poor diabetic control may be counterintuitive. The risk to the patient, from a systemic point of view, is low and by delaying surgery the density of the cataract may increase, further increasing surgical risk and complexity, further increasing risk of an ophthalmic complication.