期刊
BRITISH JOURNAL OF OPHTHALMOLOGY
卷 106, 期 11, 页码 1496-1502出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bjophthalmol-2020-317793
关键词
lens and zonules; epidemiology; vision
资金
- National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) [N01-HC-95178, N01-HC-95179, N01-HC-95180, N01-HC-95181, N01-HC-95182, N01-HC-95183, N01-HC-95184, IAA-Y1-HC-9035, IAA-Y1-HC-1010, HHSN268201100027C]
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute on Aging
- National Eye Institute
- NIH Medical Research Scholars Program (DHL) - NIH
- NIH Medical Research Scholars Program (DHL) - Doris Duke Charitable Foundation (DDCF) [2014194]
- American Association for Dental Research
- Colgate-Palmolive Company
- Genentech
- Elsevier
The study found that two-thirds of eyes in individuals with diabetes achieved good visual outcomes after cataract surgery. Factors such as level of education, preoperative vision, and diabetic retinopathy were significantly associated with postoperative visual outcomes, while systemic parameters such as HbA1C were not.
Aims To evaluate visual acuity (VA) outcomes of cataract surgery, and factors associated with good visual outcomes, among a population with diabetes. Methods Participants with type 2 diabetes enrolled in The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study and ACCORD-eye substudy. 1136 eyes of 784 ACCORD participants receiving cataract surgery during follow-up (2001-2014) were included. Of these, 362 eyes had fundus photographs gradable for diabetic retinopathy. The main outcome measure was the achievement of postoperative VA of 20/40 or better. Results In the sample of 1136 eyes, 762 eyes (67.1%) achieved good visual outcome of 20/40 or better. Factors predictive of good visual outcome were higher level of educational attainment (college vs some high school, OR 2.35 (95% CI 1.44 to 3.82)), bilateral cataract surgery (OR 1.55 (1.14 to 2.10)) and preoperative VA (20/20 or better vs worse than 20/200, OR 10.59 (4.07 to 27.54)). Factors not significantly associated (p>0.05) included age, sex, race, smoking, diabetes duration, blood pressure, lipid levels and haemoglobin A1C (HbA1C). In the subsample of 362 eyes, absence of diabetic retinopathy was associated with good visual outcome (OR 1.73 (1.02 to 2.94)). Conclusion Among individuals with diabetes, two-thirds of eyes achieved good visual outcome after cataract surgery. Notable factors associated with visual outcome included preoperative VA and diabetic retinopathy, but not HbA1C, underscoring that while certain ocular measures may help evaluate visual potential, systemic parameters may not be as valuable. Sociodemographic factors might also be important considerations. Although the current visual prognosis after cataract surgery is usually favourable, certain factors still limit the visual potential in those with diabetes.
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