Bariatric Surgery may worsen existing serious Diabetic Retinopathy: Study

It was a systemic review and meta-analysis. Researchers used MEDLINE, EMBASE, and CENTRAL databases for primary studies comparing DR in patients undergoing bariatric surgery to medical management and included a total of 14 studies comprised of 110,300 surgical and 252,289 control patients. They used a random-effects model for the meta-analysis results. The major outcome assessed was the prevalence of all DR and sight-threatening DR after surgery. They also assessed the worsening of DR within and beyond 12 months.

Upon analysis, researchers noted that surgical patients had statistically significantly lower post-operative prevalence of all DR (RR 0.17) and sight-threatening DR (RR 0.47). They found early worsening of DR and progression to sight-threatening DR had occurred more often in those with more severe DR initially. They also found after 2 months, the bariatric surgery resulted in significantly fewer patients with worsened DR (RR 0.29). They reported that the overall risk of bias was low and the estimates of relative effects had low to moderate certainty of evidence.

The authors concluded, "While bariatric surgery was associated with fewer cases of all and sight-threatening DR, early worsening was more severe in patients with existing sight-threatening DR. These findings argue for frequent monitoring during the first post-operative year".

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https://www.ajo.com/article/S0002-9394(21)00007-6/fulltext#%20