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Observational Study
. 2025 Apr 28;25(1):252.
doi: 10.1186/s12886-025-04080-1.

Risk factors for pupil changes in patients with diabetic retinopathy and cataract after phacoemulsification with intraocular lens implantation

Guilan Yi  1   2 , Hai Yu  3
Affiliations
Observational Study

Risk factors for pupil changes in patients with diabetic retinopathy and cataract after phacoemulsification with intraocular lens implantation

Guilan Yi et al. BMC Ophthalmol. .

Abstract

Background: This study aims to identify the risk factors associated with pupillary changes in patients with diabetic retinopathy (DR) and cataract undergoing phacoemulsification with intraocular lens implantation (PHACO + IOL).

Methods: This retrospective observational study included patients with DR and cataract who underwent phacoemulsification and intraocular lens implantation between February 2021 and August 2023. Patients were categorized into two groups based on the presence or absence of pupillary changes following surgery.

Results: A total of 162 patients were analyzed, with pupillary changes occurring in 33 cases (20.37%). Multivariate logistic regression analysis revealed that a longer duration of diabetes (OR = 2.73; 95% CI: 1.02-7.27, P = 0.045), higher lens nucleus grade (OR = 3.95; 95% CI: 1.58-9.89, P = 0.003), greater severity of DR (OR = 3.60; 95% CI: 1.40-9.28, P = 0.008), and intraoperative posterior lens capsule rupture (OR = 6.41; 95% CI: 1.75-23.47, P = 0.005) were significant risk factors for postoperative pupillary changes in DR patients undergoing PHACO + IOL.

Conclusion: Phacoemulsification with intraocular lens implantation is an effective treatment for patients with DR and cataract. However, factors such as the duration of diabetes, severity of DR, and intraoperative complications are associated with an increased risk of pupillary changes. Therefore, rigorous blood glucose control, adherence to standardized surgical protocols, and preventive care are recommended to optimize patient outcomes.

Trial registration: Not applicable.

Clinical trial number: Not applicable.

Keywords: Cataract; Diabetic retinopathy; Influencing factors; Lens nuclear grading; Proliferative phase; Pupillary changes.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of Deyang People’s Hospital. The procedures were conducted in accordance with the ethical standards set forth by the Committee on Human Experimentation and the Helsinki Declaration of 1964, as revised in 2013. All patients in this study voluntarily joined this study with informed consents. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Incidence of pupillary changes. The purple area indicates the occurrence of pupillary changes and the blue area indicates the percentage of patients without pupillary changes
See this image and copyright information in PMC

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