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Peer-reviewedCC BY-NC 4.0Diabetes, Metabolic Syndrome and Obesity

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

  • Shuang Li1,2,3
  • Yuxuan Liu1,4
  • Jinsong Zhang5
  • Lijuan Zhang2,3
  • Jing Wang1,5,6
6 affiliations
  1. 1Shenyang Aier Institute of Precision Medicine, Shenyang, Liaoning, 110005, People’s Republic of China
  2. 2Department of Nursing, Liaoning Aier Eye Hospital, Shenyang, Liaoning, 110005, People’s Republic of China
  3. 3Fundus Disease Nursing Group, Aier Eye Hospital Group Co. Ltd, Shenyang, Liaoning, 110005, People’s Republic of China
  4. 4Shenyang Aier Cataract Research Institute, Shenyang, Liaoning, 110005, People’s Republic of China
  5. 5Department of Cataract, Liaoning Aier Eye Hospital, Shenyang, Liaoning, 110005, People’s Republic of China
  6. 6Department of Cataract, Shenyang Aier Excellence Eye Hospital, Shenyang, Liaoning, 110005, People’s Republic of China
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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.

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Cite

BibTeXRIS
BibTeX
@article{li2026shortterm,
  title = {{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}},
  author = {Shuang Li and Yuxuan Liu and Jinsong Zhang and Lijuan Zhang and Jing Wang},
  journal = {Diabetes, Metabolic Syndrome and Obesity},
  year = {2026},
  month = oct,
  doi = {10.2147/dmso.s641495},
  url = {https://doi.org/10.2147/dmso.s641495},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - 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
AU  - Shuang Li
AU  - Yuxuan Liu
AU  - Jinsong Zhang
AU  - Lijuan Zhang
AU  - Jing Wang
PY  - 2026
DA  - 2026/10/30
JO  - Diabetes, Metabolic Syndrome and Obesity
DO  - 10.2147/dmso.s641495
UR  - https://doi.org/10.2147/dmso.s641495
AB  - 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.
SN  - 1178-7007
ER  -