Comparison of corneal endothelial changes following phacoemulsification in diabetic and non-diabetic patients

Abstract

Purpose: To study corneal endothelial changes post phacoemulsification in diabetic and non-diabetic patients.

Methods: A comparative, prospective, observational study was conducted on 100 diabetic and 100 non-diabetics who underwent phacoemulsification. All patients were operated by the same surgeon by using the phaco chop technique to exclude any surgeon-related bias. Endothelial cell count, CCT, and coefficient of variance (CV) were measured with a specular microscope along with BCVA preoperatively and at 1 week, 4 weeks, and 3 months postoperatively. For statistical analysis, data were analyzed by using SPSS (version 27.0; SPSS Inc., Chicago, IL, USA). Data were summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. Chi square test, independent sample T test, and paired T test were used to compare the data. P ≤ 0.05 was considered statistically significant.

Results: : Postoperatively at 1 week, 4-week, and 3 months follow-up intervals, the mean endothelial cell count and coefficient of variance were significantly higher, and the mean percentage of hexagonal cells was significantly lower in non diabetic as compared to the diabetic group. A significant difference in mean central corneal thickness of the two groups was observed at 1-week and 4-weeks postoperative intervals; at both these intervals, the mean value was significantly higher in non diabetic as compared to the non-diabetic group. However, at 3-months post-operative interval, the difference between the two groups was not significant statistically. Mean BCVA values were significantly higher in diabetic as compared to the diabetic group at all three follow-up intervals.

Conclusion: : The findings of the present study show that endothelial cell characteristics are adversely affected in diabetic eyes as compared to non-diabetic patients undergoing phacoemulsification; this might also have an effect on the visual outcomes.

Keywords: BCVA; central corneal thickness; corneal endothelium; diabetes; endothelial cell count; hexagonality; phacoemulsification.