Bariatric surgery might aggravate proliferative diabetic retinopathy

This study aimed to assess the changes experienced by patients with proliferative diabetic retinopathy (PDR) after bariatric surgery (BS).

This retrospective observational study includes 37 eyes of 21 patients with PDR who underwent BS at a tertiary university hospital over the period of 2014-2018. The control group (CG) comprised 37 eyes of 27 patients with PDR who attended the same research hospital for diabetes care without undergoing BS. Preoperative and postoperative glycated haemoglobin (HbA1c) levels, weight and diabetic retinopathy screening results were collected from the medical records of the patients. Patients who had undergone preoperative retinal screening and at least one postoperative retinal screening were included in the analysis.

Both groups exhibited statistically significant visual acuity (VA) loss at 6 months and 1 year (p < 0.001). At postoperative 6 months the VA loss experienced by the control BS group was significantly more severe than that experienced by the CG (p = 0.03). The first-year HbA1c levels of the BS group were significantly lower than those of the CG (p = 0.02). The BS group had significantly higher intraocular haemorrhage (p = 0.04), neovascular glaucoma (p = 0.04) and retinal vein occlusion (p = 0.04) rates than the CG group. All complications occurred at different patients.

Patients with PDR who received BS showed more severe retinopathy than patients who were matched for age, sex, HbA1c levels and follow-up duration and who did not receive BS.