Cataract rate higher in diabetics with immunosuppression

PARIS — With 5 years follow-up, significantly more patients with type 1 diabetes who underwent full immunosuppression after transplant surgery required cataract surgery compared to patients who had less immunosuppression, a study found.

Tomas Sosna, MD, and colleagues presented their findings in diabetic patients who underwent combined kidney and pancreas transplantation in a poster here at the European Society of Cataract and Refractive Surgeons meeting.

Patients in the study were divided into two groups. One group, including 79 patients with an average age of 41 years, had functional transplants and underwent full immunosuppressive therapy. A second group, including 81 patients with an average age of 39.3 years, had failed transplantations and so received immunosuppressive therapy for less than 6 weeks.

Significant differences were seen between groups in mean length of follow-up and in a marker of diabetic status. Mean follow-up was 69 ± 2.9 months for patients in the group with functioning transplants and 79 ± 2.8 months for patients in the group with nonfunctioning transplants (P < .05). Glycosylated hemoglobin was 5.6 ± 0.7% in the group with functioning transplants and 8.2 ± 1.6% in the group with nonfunctioning transplants (P < .01).

In the group with functioning transplants, 26 patients required cataract surgery during follow-up, compared with 10 patients in the other group

There was one case of new macular edema in each group. There were three cases of acceleration of existing macular edema in the group with nonfunctioning transplants and none in the other group.

Immunosuppressive therapy with corticosteroids “no doubt” accelerated the development of cataracts, the authors said. The effects of other immunosuppressive agents is not clear, they noted.