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Periocular surgery risk after glucagon-like peptide-1 receptor agonist therapy for type 2 diabetes
Abhimanyu S Ahuja1, Alfredo A Paredes2, Benjamin K Young1
1Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA.
Purpose:
To evaluate the association between GLP-1RA therapy and the hazard of involutional periocular surgical procedures among patients with type 2 diabetes.
Methods:
This retrospective cohort study used the TriNetX electronic health record database. Adults aged 45 years and older with type 2 diabetes were included. A GLP-1RA cohort was created with evidence of continued therapy defined by a second prescription at least 1 year after initiation. The comparison cohort included patients prescribed other antidiabetic medications, excluding GLP-1RAs. Propensity score matching balanced demographics, comorbidities, and insulin use. The primary outcomes were the hazards of periocular surgery during four nonoverlapping 9-month intervals (0-9, 9-18, 18-27, and 27-36 months) and cumulatively over 0-36 months.
Results:
GLP-1RA use was associated with a higher hazard of upper eyelid blepharoplasty (HR range: 1.988-2.788), blepharoptosis repair (HR range: 1.322-1.813), and brow ptosis repair (HR range: 1.683-2.393) compared with other antidiabetic medications (all p ≤ 0.028). Elevated hazard occurred within 0-9 months of treatment and generally increased through 18-27 months.
Conclusions:
GLP-1RA therapy was associated with an increased hazard of involutional periocular surgical procedures compared with other antidiabetic medications, suggesting a potential association between GLP-1RA use and periocular soft tissue changes.
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