Corneal integrity and thickness of central fovea after phacoemulsification surgery in diabetic and nondiabetic cataract patients

Abstract

Introduction: Here we intended to investigate the changes in corneal endothelial cells and foveal thickness after phacoemulsification surgery on the eyes of diabetic and non-diabetic cataract patients.

Material and methods: A total of 120 cataract patients who were scheduled for phacoemulsification surgery and intraocular lens implantation were recruited and divided into 2 categories according to the diagnosis of diabetes mellitus. Changes in integrity, endothelial cell density (ECD), coefficient of variation (CV), percentage of hexagonal cells (PHC), central corneal thickness (CCT), and central foveal thickness (CFT) were all recorded at preoperative day 1 and postoperative day 3, 1 week, 1 month, 3 months and 6 months.

Results: None of the recorded variables showed any difference between the nondiabetic and diabetic groups before surgery (p > 0.05). During the postoperative 6 months, ECD and PHC decreased and CV increased in both groups (all p_time < 0.05), whereas CCT and CFT fluctuated in both groups significantly (both p_time < 0.05), with their individual peaks at postoperative 1 week in the diabetic group. The groups differed significantly in ECD, PHC, and CV at each time point postoperatively (all p_group < 0.05). Furthermore, the diabetic group had improved CFT during the postoperative 1 month and higher CCT during the 6 months postoperatively than the nondiabetic group (all p_group < 0.05). The time and group interactions were significant for ECD, CV, PHC, CCT and CFT (all p_{group × time} < 0.05).

Conclusions: The diabetic group had more changes in corneal endothelial cells and foveal thickness than the nondiabetic group postoperatively.

Keywords: corneal integrity; diabetes mellitus; endothelial cell density; phacoemulsification.

Figure 1

Comparisons of endothelial cell density (A), percentage of hexagonal cells (B), and coefficient of variation (C) between the diabetic and nondiabetic groups at preoperative day 1 and postoperative day 3, 1 week, 1 month, 3 months, and 6 months. Data are shown as mean ± standard error (SE). *Diabetic group differed from nondiabetic group postoperatively at the time point (pgroup < 0.05)

Figure 2

Comparison of central corneal thickness (A) and central foveal thickness (B) between the diabetic and nondiabetic groups at preoperative day 1 and postoperative day 3, 1 week, 1 month, 3 months, and 6 months. Data are shown as mean ± standard error (SE). *Diabetic group differed from nondiabetic group postoperatively at the time point (pgroup < 0.05)