Work

Short-Term Macular Structural Changes and 3-Month Visual Outcomes After Cataract Surgery in Patients with Type 2 Diabetes: Associations with Preoperative HbA1c and OCT Findings

Year: 2026

Type: article

Abstract: Objective: To examine early macular structural changes and 3-month visual outcomes after cataract surgery in patients with type 2 diabetes mellitus (T2DM) and their associations with preoperative glycated hemoglobin (HbA1c). Methods: This retrospective cohort included 360 patients with T2DM undergoing phacoemulsification, stratified by HbA1c <7.0% or ≥7.0% (n=180 each). Foveal thickness (FT) and external limiting membrane/ellipsoid zone integrity were assessed preoperatively and within 3 days postoperatively. Pseudophakic cystoid macular edema (PCME) was monitored through 3 months, and poor visual recovery was defined as 3-month best corrected visual acuity (BCVA) >0.3 LogMAR. Logistic regression adjusted for diabetic retinopathy stage, preoperative BCVA, and preoperative FT. Results: Early FT increased in both groups, without significant between-group differences in FT or membrane integrity. PCME occurred in 17.78% vs 4.44%, and poor visual recovery in 19.44% vs 5.56%, of the HbA1c ≥7.0% and <7.0% groups, respectively (both *P*<0.001). Higher HbA1c was associated with PCME (adjusted odds ratio [aOR]=1.525 per 1% increase, 95% CI: 1.154-2.014) and poor visual recovery (aOR=2.724, 95% CI: 1.556-4.768). These associations persisted among patients without diabetic retinopathy. HbA1c showed limited discrimination for PCME (AUC=0.658) and moderate discrimination for poor visual recovery (AUC=0.724). Conclusion: Higher preoperative HbA1c was associated with PCME and poor 3-month visual recovery after adjustment for baseline ocular characteristics. HbA1c alone provided limited-to-moderate discrimination, and the sample-derived cutoffs should be considered exploratory.

Source: Diabetes Metabolic Syndrome and Obesity

DOI: 10.2147/dmso.s641495

Authors: Shuang Li, Yuxuan Liu, Jinsong Zhang, Lijuan Zhang, Jing Wang

Institution: Aier Eye Hospital Group (China)

Language: English

Topic: Intraocular Surgery and Lenses

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836