Earlier onset of type 2 diabetes mellitus as a risk factor for Irvine-Gass syndrome.

Abstract

Purpose: To investigate the association between age at type 2 diabetes mellitus (T2DM) onset and the risk of Irvine-Gass Syndrome (IGS) following uneventful phacoemulsification with intraocular lens implantation (PEI).

Methods: This retrospective case-control study analyzed 190 participants (39 IGS, 151 non-IGS) who underwent uneventful PEI. Comprehensive demographic, systemic, and perioperative data were collected. Statistical analyses included between-group comparisons, logistic regression, and Receiver Operating Characteristic (ROC) curve analysis to identify independent IGS predictors and determine optimal risk-stratification thresholds.

Results: While overall T2DM prevalence was comparable between groups (p = 0.168), IGS patients had significantly earlier diabetes onset (49.05±8.61 vs. 59.23±10.65 years, p < 0.001). Multivariable analysis confirmed younger T2DM onset age as an independent IGS predictor (OR = 1.094 per year decrease, 95% Confidence Interval [95% CI 1.015‒1.179], p = 0.019). ROC analysis identified T2DM onset age ≤ 55.5-years as the optimal predictive threshold (Area Under the ROC Curve [AUROC = 0.774], sensitivity = 73.7%, specificity = 78.9%). Participants stratified by this threshold showed significantly different IGS incidence (non-diabetic: 15.32%; younger-onset T2DM: 56.67%; older-onset T2DM: 10.20%; p < 0.001). Younger-onset T2DM patients had approximately 5.5-fold higher IGS odds versus non-diabetics (adjusted OR = 5.499, 95% CI 2.104‒14.373, p = 0.001).

Conclusions: Earlier T2DM onset (≤ 55.5-years) is a strong independent risk factor for IGS following uneventful PEI. This threshold provides a clinically useful tool for preoperative risk stratification, particularly valuable for identifying high-risk diabetic patients who may benefit from enhanced perioperative monitoring and management.