Cataract surgical outcomes in diabetic patients: case control study

Predictors of Cataract Surgery Among US Adults: NHANES 2007-2008

PURPOSE

Cataract, characterized by the clouding of the lens, is the leading cause of blindness and visual impairment worldwide. While cataract surgery is an effective treatment, it carries substantial costs, potential complications, and limited accessibility for those facing financial barriers. Hence, this study aimed to identify the sociodemographic, behavioral, medical, and occupational risk factors of cataract development among adults aged 40 and above.

METHODS

This cross-sectional study included 2866 participants from the National Health and Nutrition Examination Survey (NHANES) cycle from 2007 to 2008. We utilized a purposeful selection approach to identify the most suitable predictors for cataract surgery. We further used a multivariate logistic regression procedure that accounted for complex sampling design, to assess the main effect of each predictor, entered jointly into the model.

RESULTS

Age, blood pressure, and diabetes were identified as predictors of cataract surgery. Each additional year of age increased the odds of undergoing cataract surgery by 15% (OR: 1.15; 95% CI: 1.13-1.16). Participants with high blood pressure had a 38% higher likelihood of cataract surgery (OR: 1.38; 95% CI: 1.11-1.73), while those with diabetes faced a 63% higher likelihood (OR: 1.63; 95% CI: 1.27-2.09).

CONCLUSIONS

Managing diabetes and blood pressure, especially among older adults, may be crucial in delaying cataract progression.

Visual outcome after phacoemulsification with lens implant in diabetic and non-diabetic patients; A comparative study

Objective:

To compare the visual outcomes of phacoemulsification surgery with intraocular lens (IOL) in persons with and without diabetes at end of follow-up.

Methods:

This was a comparative, cross sectional, observational study with Non-probability, purposive sampling. After approval from “Research Ethical Committee of Isra Post-graduate Institute of Ophthalmology Karachi, 92 patients with cataract in one eye were selected. Patients were divided into two groups. Group A consisted of 48 diabetics and group B consisted of 44 non- diabetics with or without diabetes in the age group ≥ 30 years were included. Patients with small Pupil, Pseudo exfoliation Syndrome, Diabetic Retinopathy, and positive history of Uveitis, Glaucoma, and Macular Degeneration were excluded. Data analysis was performed by SPSS Version 20.0.

Results:

Best Corrected Visual Acuity (BCVA) in diabetic patients improved from 0.813 ± 0.181 Log MAR pre operatively to 0.183 ± 0.143 after the period of six months post-operatively. Corresponding results in non-diabetics were 0.66 ± 0.31 and 0.08 ± 0.092 Log Mar (P value = 0.001). If WHO criteria was considered, 87.5% diabetics and 92% non-diabetics achieved normal vision (Log Mar 0 to 0.5; ≥ 6/12,) on the first post-operative day. Remaining 12.5% diabetics and 8% non-diabetics achieved moderate vision (0.6 to 1 Log MAR) on first post-operative day improving to normal vision within a week.

Conclusion:

Visual outcomes in diabetics after phacoemulsification with intra ocular lens implant is almost as good as that in non-diabetic patient if the diabetics have no retinopathy and have good glycemic control.

Ameliorative effects of thymoquinone against eye lens changes in streptozotocin diabetic rats

The possible protective effect of thymoquinone against eye lens changes in diabetic rats was investigated. Following diabetes induction by a single injection of streptozotocin (45 mg/kg, i.p.), thymoquinone was administered in three different doses (20, 40, and 80 mg/kg/day, p.o.) for 12 weeks. Thymoquinone significantly and dose-dependently attenuated the hypoinsulinemia and hyperglycemia in diabetic rats. Also, thymoquinone (particularly 40 and 80 mg/kg) significantly decreased the elevations of malondialdehyde, nitric oxide, tumor necrosis factor-α, glycated proteins, aldose reductase activity, sorbitol level, and caspase-3 activity in the lens tissues of diabetic rats. In addition, thymoquinone (particularly 40 and 80 mg/kg) significantly ameliorated the diabetes-induced reductions of glutathione peroxidase, superoxide dismutase, and catalase activities, and total and soluble protein contents in the lens tissues. It was concluded that thymoquinone significantly protected the lens tissue against changes induced by diabetes in rats through its antioxidant, anti-inflammatory, and antidiabetic effects.

Meta-analysis of the risk of cataract in type 2 diabetes

Background

This meta-analysis aimed to investigate the association between type 2 diabetes (T2D) and the risk of cataract.

Methods

Databases of Pubmed, Embase, and SpringerLink were retrieved for observational studies published before November 2013. The odds ratio (OR) and 95% confidence interval (CI) were used for estimating the association. All statistical analyses were performed by Stata 10.0 software.

Results

A total of 8 studies involving 20837 subjects were included in the meta-analysis. The risk of any cataract (AC) in T2D patients was higher than that in non-diabetic subjects (OR = 1.97, 95% CI: 1.45-2.67, P < 0.001). The risks of cortical cataract posterior (CC) (OR = 1.68, 95% CI: 1.47-1.91, P < 0.001) and posterior subcapsular (PSC) (OR = 1.55, 95% CI: 1.27-1.90, P < 0.001) were significantly elevated in T2D patients, while no significant association was found in nuclear sclerosis (NS) (OR = 1.36, 95% CI: 0.97-1.90, P = 0.070).

Conclusion

T2D patients had a higher risk of cataracts, excepting NS. Special attention should be paid on the ophthalmic extermination, especially for cataract in T2D patients.