Abstract
This nationwide retrospective case-control study was aimed at elucidating the risk from cataract surgery in end-stage renal disease (ESRD) patients. Cataract surgery patients were identified using the diagnostic and procedural codes for International Classification of Diseases, 9th Revision, Clinical Modification from Taiwan’s National Health Insurance Research Database. ESRD patients were selected as cases, while propensity scores for age, sex, comorbidities and year-of-surgery-matched patients without chronic kidney disease constituted the controls. Patients who had undergone eye surgery within 3 years before cataract surgery were excluded. The main outcome measures were target cataract surgery-related complications within 3 months after surgery. A total of 352 cases and 1,760 controls were analysed. Patients with ESRD had a 5.06-fold (95% CI: 2.36–10.87; p < 0.001) risk of vitreous haemorrhage and a 2.74-fold (95% CI: 1.20–6.27; p = 0.017) risk of re-operation for dropped nucleus or vitreous complications. Non-diabetic ESRD patients had a 3.49-fold (95% CI: 1.36–8.91; p = 0.009) risk of corneal oedema. In conclusion, ESRD patients have a higher risk of vitreous haemorrhage, re-operation for dropped nucleus or vitreous complications and corneal oedema (non-diabetic patients) after cataract surgery. Pre-surgery corneal examination, surgery procedure and medication adjustment, closer and longer post-surgery follow-up may lower the risk and improve the visual outcome.
Highlights
This nationwide retrospective case-control study was aimed at elucidating the risk from cataract surgery in end-stage renal disease (ESRD) patients
In the remaining 24,527 patients, 352 with ESRD were identified as the case group, and 1,760 patients with matching age, sex, and year of surgery were selected as the control group
The percentage of hypertension (HTN), diabetes mellitus (DM) and myopia in the ESRD group was similar to the matched control group
Summary
This nationwide retrospective case-control study was aimed at elucidating the risk from cataract surgery in end-stage renal disease (ESRD) patients. ESRD patients have a higher risk of vitreous haemorrhage, reoperation for dropped nucleus or vitreous complications and corneal oedema (non-diabetic patients) after cataract surgery. Cataract surgery is a minor procedure, complications sometimes develop that influence the visual outcome. A few studies have reported cataract surgery-related risk in ESRD patients[6,7], and these studies involved only a small number of patients and no control group. The purpose of the present study was to elucidate the risk of cataract surgery-related complications in patients receiving dialysis and to compare this risk to those in patients without chronic kidney disease (CKD) or ESRD. The study may inform better patient care and improve surgical outcomes
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