Abstract: FR-PO878

The Cataract Surgery Related Complications in Patients with ESRD

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Author

  • Wu, Chia-Chun, Chi Mei Medical Center, Tainan, Taiwan
Background

Higher surgery risk in end stage renal disease (ESRD) patients is well known, but most reports focus on major surgeries. Cataract is the most common cause of visual loss worldwide. Although catarct surgery is a minor surgery, surgery related complications still happen. Herein, we want to know if ESRD patients have higher risk of cataract surgery related complications.

Methods

The National Health Insurance Research Database in Taiwan was used to identify patients who received cataract surgery. Patients with regular hemodialysis(HD) or peritoneal dialysis longer than 3 months were selected as study group. Control group is patients without chronic kidney disease and matched on age, gender and surgery year. Other exclusion criteria is any eye surgery within 3 years prior cataract surgery.The main outcome measures are cataract surgery–related complications within 3 months after surgery. Conditional logistic regression was used for the risk of complications.

Results

Patients with ESRD have higher percentage of hypertension, diabetes mellitus and more likely to have a cataract surgery in medical centers. Patients with ESRD have a 6.81 times higher risk to have vitreous hemorrhage within 3 months after cataract surgery. The odds ratios of vitreous hemorrage are 4.20, 4.86, 9.8 in the 1st, 2nd and 3rd month individually.

Conclusion

Patients with ESRD have a higher risk of vitreous hemorrhage after cataract surgery. Heparin is frequently used during HD to prevent clot formation in blood circuit, this analysis result might afford a reference to adjust the heparin dose in HD patients after receiving cataract surgery.

The multiple complications after cataract surgery within 3 months in ESRD patients and Control group
 ESRD patients (N=439)Controls (N=1317)Adjusted OR(95% CI)P-value
Cornea edema13(2.96)27(2.05)1.14(0.54-2.40)0.7317
Glaucoma40(9.11)125(9.49)0.72(0.47-1.10)0.1257
Endophthalmitis1(0.23)5(0.38)0.42(0.04-4.58)0.4773
Vitreous hemorrage20(4.56)4(0.30)6.81(1.98-23.35)0.0023*
Retinal detachment3(0.68)5(0.38)1.66(0.31-8.84)0.5523
Dropped nucleus10(2.28)11(0.84)2.28(0.83-6.31)0.1119
Wound dehiscence1(0.23)4(0.30)0.61(0.05-7.55)0.7034

ESRD=End stage renal disease; OR=Odds ratio. Adjusted factors :Hypertension, Diabetes mellitus, Myopia, Hospital level, use Anti-platelet drugs or anticoagulant