The Influence of Diabetes Status on the Rate of Cataract Surgery Following Pars Plana Vitrectomy.

ABSTRACT

PURPOSE: We aimed to evaluate the association between diabetic status and the rates of cataract extraction (CE) following pars plana vitrectomy (PPV). DESIGN: Retrospective cohort, multicenter database study. PARTICIPANTS: Patients were selected from an insurance claims database (PharMetrics LifeLink) that included persons who had filed claims between 2006 and 2015 in the United States. METHODS: We analyzed the records of 22 146 patients who underwent PPV performed by 2705 retina physicians. The vitrectomy group included patients ≥18 years of age who had undergone PPV. The control group included patients who were matched to the vitrectomy group 12 based on sex, diabetes mellitus (DM) status, region of the United States, and Charleston Comorbidity Index. MAIN OUTCOME MEASURES: Hazard ratios (HRs) and rates of cataract surgery in patients with and without diabetes who had undergone prior PPV. RESULTS: The hazard ratio for post-PPV CE was lower among patients with diabetes (3.307; 95% confidence interval [CI], 3.051-3.583) than among patients without diabetes (4.889; 95% CI, 4.670-5.119). This association was significant for all subgroups of patients with diabetes except in patients with diabetes and without retinopathy (4.086; 95% CI, 3.511-4.754). There was a significantly longer time between PPV and CE in patients with diabetes (537 days; 95% CI, 459-677 days) compared with those without diabetes (295 days; 95% CI, 278-312 days). The type of DM (type 1 vs. type 2) did not influence the rate of post-PPV cataract surgery. In persons with diabetes who underwent PPV, we observed a trend for a lower HR of cataract surgery in eyes with proliferative retinopathy (0.903; 95% CI, 0.725-1.124), and nonproliferative retinopathy (0.965; 95% CI, 0.721-1.290) compared with eyes with no retinopathy. CONCLUSIONS: Eyes of patients with diabetes had a significantly decreased risk of undergoing CE after PPV surgery compared with eyes of patients without diabetes.