Please use this identifier to cite or link to this item: https://doi.org/10.1001/jamanetworkopen.2020.8035
Title: Association of Cataract Surgery With Risk of Diabetic Retinopathy Among Asian Participants in the Singapore Epidemiology of Eye Diseases Study
Authors: Tham, Y.-C.
Liu, L.
Rim, T.H. 
Zhang, L.
Majithia, S.
Chee, M.L.
Tan, N.Y.Q.
Wong, K.-H.
Ting, D.S.W. 
Sabanayagam, C. 
Wang, J.J. 
Mitchell, P.
Wong, T.Y. 
Cheng, C.-Y. 
Issue Date: 2020
Publisher: NLM (Medline)
Citation: Tham, Y.-C., Liu, L., Rim, T.H., Zhang, L., Majithia, S., Chee, M.L., Tan, N.Y.Q., Wong, K.-H., Ting, D.S.W., Sabanayagam, C., Wang, J.J., Mitchell, P., Wong, T.Y., Cheng, C.-Y. (2020). Association of Cataract Surgery With Risk of Diabetic Retinopathy Among Asian Participants in the Singapore Epidemiology of Eye Diseases Study. JAMA network open 3 (6) : e208035. ScholarBank@NUS Repository. https://doi.org/10.1001/jamanetworkopen.2020.8035
Rights: Attribution 4.0 International
Abstract: Importance: Cataracts and diabetic retinopathy (DR) are the leading causes of acquired blindness worldwide. Although extraction is the standard treatment option for cataracts, it is also reported to increase the risk of developing DR among individuals with diabetes. Nevertheless, the association between cataract surgery and risk of DR is still not well understood, and there have been no prior population-based reports in this area. Objective: To assess the risk of developing DR after cataract surgery among individuals with type 2 diabetes. Design, Setting, and Participants: A population-based prospective cohort study was conducted among participants recruited from the Singapore Epidemiology of Eye Diseases Study. The baseline visit was conducted between June 1, 2004, and March 31, 2009, and the 6-year follow-up visit was conducted between June 1, 2011, and July 31, 2016. Statistical analysis was performed from October 1 to 31, 2019. Exposures: Cataract surgery performed before a follow-up visit, determined based on slitlamp evaluation of lens status at baseline and follow-up visits. Main Outcomes and Measures: Eyes with incidence of DR were defined as those with the presence of any DR (level ?15 based on the modified Airlie House classification system, graded from retinal photographs) at 6-year follow-up with no DR at baseline. The association between cataract surgery and incidence of DR was evaluated using a multivariable Poisson regression model with a generalized estimating equation to account for correlation between both eyes. Results: A total of 1734 eyes from 972 participants with diabetes (392 Malay individuals and 580 Indian individuals; 495 men; mean [SD] age, 58.7 [9.1] years) were included in the analysis. A total of 163 study eyes had already undergone cataract surgery at baseline, and a total of 187 eyes (originally phakic at baseline) underwent cataract surgery any time during the follow-up period. Of these 350 eyes, 77 (22.0%) developed DR. Among the 1384 eyes that never underwent cataract surgery, 195 (14.1%) developed DR. After adjustments for age, sex, race/ethnicity, baseline hemoglobin A1c level, duration of diabetes, random blood glucose level, antidiabetic medication use, hypertension, body mass index, and smoking status, multivariable regression analysis showed that any prior cataract surgery was associated with incidence of DR (relative risk, 1.70; 95% CI, 1.26-2.30; P?=?.001). Subgroup analyses by race/ethnicity showed similar associations in both Malay individuals (relative risk, 1.73; 95% CI, 1.13-2.69; P?=?.02) and Indian individuals (relative risk, 1.93; 95% CI, 1.33-2.80; P?
Source Title: JAMA network open
URI: https://scholarbank.nus.edu.sg/handle/10635/196369
ISSN: 25743805
DOI: 10.1001/jamanetworkopen.2020.8035
Rights: Attribution 4.0 International
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