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The following is a summary of “Pre-Operative Glycemic Control and Acute Endophthalmitis after Cataract Surgery in US Veterans with Diabetes Mellitus,” published in the March 2025 issue of Ophthalmology by Armbrust et al. 

Researchers conducted a retrospective study to specify whether pre-operative glycemic control predicted the occurrence of acute endophthalmitis after cataract surgery.  

They analyzed data from individuals with diabetes mellitus (DM) who underwent cataract surgery (2010-2022) in the US Veterans Affairs (VA) Health Care System. Data from the VA Corporate Data Warehouse (CDW) included demographics, clinical characteristics, DM diagnosis timing, and pre-operative hemoglobin A1c (HbA1c) levels measured within 0-6 months before surgery. Acute post-operative endophthalmitis cases were identified using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes and confirmed through chart review. Univariable and multivariable analyses assessed the association between pre-operative HbA1c levels and post-operative endophthalmitis.  

The results showed that among 1,90,393 individuals with DM who underwent cataract surgery and had HbA1c recorded within 0-6 months before surgery, 157 (0.08%) developed acute post-operative endophthalmitis. Mean ± standard deviation pre-operative HbA1c was 7.1 ± 1.4% in those with endophthalmitis and 7.3 ± 1.5% in controls, but this difference was not significant (P = 0.14). A subanalysis of individuals with HbA1c measured 0-2 months before surgery also showed no association with endophthalmitis (P = 0.31). Multiple logistic regression indicated no significant link between pre-operative glycemic control and post-operative endophthalmitis (adjusted odds ratio, 0.89; 95% confidence interval, 0.79 – 1.01; P = 0.08).  

Investigators concluded that pre-operative HbA1c levels did not correlate with post-operative endophthalmitis risk in patients with diabetes undergoing cataract surgery. 

Source: aaojournal.org/article/S0161-6420(25)00186-1/abstract