Журнал хирургии глаза и катаракты Открытый доступ

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Influence of Underlying Diabetes Mellitus and Hypertension on Blood Pressure Alterations in Japanese Outpatient Cataract Surgery Patients

Tanaka S, Hayashi Y, Sumioka T, Kokado M, Ishikawa N, Takeshi M, Shizuya S

Background: We gathered data on blood pressure (BP) fluctuations from the period before to the completion of surgery from the medical records of patients undergoing outpatient cataract surgery in Japanese.

Methods and findings: The subjects were 1,529 patients (675 men and 854 women) who underwent first-time outpatient cataract surgery under local anesthesia at the Wakayama Medical University Hospital, Japan, between January 2013 and December 2014. The age of the patients ranged from 20 to 95 years (mean: 73.1 ± 9.8 years). Patients taking oral antihypertensive(s) were assigned to a “hypertension group,” and patients receiving medication for diabetes were assigned to a “diabetes group.” BP values 1 h before surgery, upon entering the operating room (OR), and upon completion of surgery and peak intraoperative BP were analyzed. Compared with BP 1 h before surgery, peak systolic BP (SBP) in all patients was significantly elevated upon entering the OR. Compared with the mean SBP of all patients, that of patients with underlying hypertension was higher before surgery, upon entering the OR, during and after surgery. In diabetes patients, SBP 1 h before surgery was not higher than that of the total patient sample; however, it was significantly higher upon entering the OR, during and upon completion of surgery.

Discussion: Peak systolic BP was significantly elevated upon entering the OR and during surgery in patients undergoing outpatient cataract surgery. In diabetic patients, no significant differences were noted for SBP 1 h before surgery amongst the entire sample. However, SBP upon entering the OR, during and upon completion of surgery was significantly elevated in these patients compared with that in the entire sample. Particular caution should be paid to BP fluctuations associated with cataract surgery, and a full explanation of the risks of surgery should be given to diabetic patients before surgery.