The problems of obesity and diabetes have increased worldwide, and bariatric surgery is becoming an increasingly acceptable management plan. Some recognize the procedure as an effective treatment that facilitates substantial sustained weight loss and induces drastic and rapid glycemic control that consequently results in the remission of type 2 diabetes. But new research suggests it can have negative effects as well. Researchers in Turkey have found that patients with proliferative diabetic retinopathy (PDR) who received bariatric surgery showed more severe retinopathy than patients who did not receive the surgery but were otherwise matched for age, sex, HbA1c levels and follow-up duration.

The retrospective observational study included 37 eyes of 21 patients with PDR who underwent bariatric surgery. The control group comprised of 37 eyes of 27 patients with PDR who attended the same research hospital for diabetes care without undergoing the surgery.

The first-year HbA1c levels of the bariatric surgery group were significantly lower than those of the control group. However, the surgery patients had significantly higher intraocular hemorrhage, neovascular glaucoma and retinal vein occlusion rates than the control patients. The researchers found that 80.9% of this group had one of these serious eye complications.

The study emphasizes that its results provide evidence that the severity of DR at baseline is an important sign of post-bariatric surgery DR grade. The researchers suggest that continued DR monitoring post-op is particularly important for patients with PDR.

Sever O, Horozoglu F. Bariatric surgery might aggravate proliferative diabetic retinopathy. Acta Ophthalmol. January 7, 2020. [Epub ahead of print].