Association Between Preoperative Systemic Inflammatory Indices and Visual Outcomes After Cataract Surgery.

AIM: To evaluate the association between preoperative systemic inflammatory indices (systemic immune-inflammation index [SII], systemic inflammation response index [SIRI], and aggregate index of systemic inflammation [AISI]) and poor visual outcomes following cataract surgery.

METHODS

This retrospective study included 240 patients who underwent cataract surgery between April 2022 and June 2025. SII, SIRI, and AISI were calculated from complete blood counts obtained within 7 days preoperatively. Poor visual outcome at 4 weeks postoperatively was analyzed using multivariable logistic regression and restricted cubic spline models, with adjustment for potential confounders.

RESULTS

The mean age was 69 years, and 67.1% of participants were female. SII demonstrated a nonlinear association with poor postoperative visual outcomes (p for nonlinearity = 0.029), with increased odds observed at SII values of 500-1000 and at extremely low levels. Compared with the lowest tertile, the highest SII tertile was associated with a significantly increased risk (adjusted odds ratio [OR] 2.790, 95% confidence interval [CI] 1.209-6.615; p = 0.018). After adjustment for sex, body mass index (BMI), and intraocular pressure, SIRI (tertile 3 vs. tertile 1: OR 2.019, 95% CI 1.035-3.997; p = 0.041) and AISI (tertile 2 vs. tertile 1: OR 1.977, 95% CI 1.017-3.898; p = 0.046) were also associated with poor visual outcomes. In multivariable analyses, SII and AISI remained independently associated with poor postoperative vision (OR 2.790, 95% CI 1.209-6.615; p = 0.018; OR 2.104, 95% CI 1.016-4.432; p = 0.047).

CONCLUSIONS

Preoperative SII, SIRI, and AISI were significantly associated with worse short-term visual outcomes after cataract surgery. These indices, particularly SII and AISI, may provide clinically useful information for perioperative risk stratification. Further prospective validation studies and investigation of targeted anti-inflammatory strategies are warranted.