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High HbA1c Level as A Risk Factor of Low Tears Secretion After the Phacoemulsification Surgery

Ni Made Ayu Surasmiati , Ida Ayu Ary Pramita, - Siska, I Gusti Ayu Made Juliari, I Wayan Gede Jayanegara

Ni Made Ayu Surasmiati
Ophthalmology Department, Faculty of Medicine Udayana University/ Sanglah General Hospital Denpasar Bali. Email: ayuzhuras@gmail.com

Ida Ayu Ary Pramita
Ophthalmology Department, Faculty of Medicine Udayana University/ Sanglah General Hospital Denpasar Bali

- Siska
Ophthalmology Department, Faculty of Medicine Udayana University/ Sanglah General Hospital Denpasar Bali

I Gusti Ayu Made Juliari
Ophthalmology Department, Faculty of Medicine Udayana University/ Sanglah General Hospital Denpasar Bali

I Wayan Gede Jayanegara
Ophthalmology Department, Faculty of Medicine Udayana University/ Sanglah General Hospital Denpasar Bali
Online First: March 27, 2021 | Cite this Article
Surasmiati, N., Pramita, I., Siska, -., Juliari, I., Jayanegara, I. 2021. High HbA1c Level as A Risk Factor of Low Tears Secretion After the Phacoemulsification Surgery. Bali Journal of Ophthalmology 4(2). DOI:10.15562/bjo.v4i2.89


Background: Tears secretion disorder may cause significant discomfort that will interfere with daily activities and quality of life. Diabetes mellitus (DM) patients often have tears secretion disorders as a complication of peripheral neuropathy that affects the lacrimation reflex. The HbA1c level is an indicator of glycemic control in DM patients that can illustrate complication that may occur in DM patients. Surgical procedures involving the cornea, such as phacoemulsification, are thought to interfere with the tear secretion. This study aims to prove that high HbA1c level is a risk factor of low tear secretion in DM patients after the phacoemulsification surgery.

Method: This case-control study was conducted at the Eye Polyclinic of Sanglah General Hospital and Indera Hospital Denpasar Bali, from June 2013 to November 2013. A total of 70 DM patients who had undergone phacoemulsification surgery 12-16 weeks before the data collection was classified into low tear secretion (Schirmer I test <10 mm) group and normal tear secretion (Schirmer I test ?10mm) group. The HbA1c levels were measured to assess their glycemic control for the last 3 months.

Result: Based on multivariate analysis using logistic regression, the adjusted odds ratio for HbA1c level was 2.44 (95%CI 0.778 – 7.633).

Conclusion: High HbA1C levels (>7%) increase the risk of low tear secretion in DM patients after phacoemulsification surgery.

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