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. 2023 Nov;37(16):3392-3397.
doi: 10.1038/s41433-023-02515-x. Epub 2023 Apr 18.

Effects of chewing tobacco on corneal endothelium in patients with diabetes mellitus

Ashok Jha  1 , Aditya Verma  2 , Charima Priya  3
Affiliations

Effects of chewing tobacco on corneal endothelium in patients with diabetes mellitus

Ashok Jha et al. Eye (Lond). 2023 Nov.

Abstract

Objective: To determine the impact of tobacco chewing on corneal endothelial structure in patients with diabetes mellitus (DM).

Methods: Corneal endothelial parameters (endothelial cell count, ECD; coefficient of variation, CV; hexagonality, Hex, and central corneal thickness, CCT) were analysed in 1234 eyes of 1234 patients using non-contact specular microscopy (EM 4000 Tomey Nishi-Ku, Nagoya, Aichi, Japan). The study group (with a present history of tobacco chewing) comprising of 948 subjects, with 473 having DM was compared with age and gender-matched control group comprising of 286 subjects (139 having DM) with no history of tobacco use in any form.

Results: Tobacco chewers had a significantly reduced ECD (P = 0.024) and Hex (P = 0.009) as compared with non-chewers. Similar results were noted in ECD (P = 0.004) and Hex (P = 0.005) in patients with DM. Tobacco chewers had a significantly decreased ECD values among males, HbA1C ≤ 7.5% and duration of DM ≤ 20 years, and significantly decreased Hex among those with >50 years of age, females, and duration of DM > 20 years. The CV and CCT values were comparable between the study and the control groups. Tobacco chewers showed a significant association of ECD with age, HbA1C, and duration of DM; CV with HbA1C; Hex with age and duration of DM; and CCT with gender, age, HbA1C and duration of DM.

Conclusions: Tobacco chewing may negatively impact corneal health, especially confounded by additional factors like age and DM. These factors must be accounted for in the pre-operative evaluation of such patients prior to any intra-ocular surgery.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Average values of study parameters in chewers versus non-chewers.
Bar diagram illustrating the corneal endothelial and central corneal thickness parameters in tobacco chewers and non-chewers.
See this image and copyright information in PMC

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References

    1. Online resource: https://www.who.int/news-room/fact-sheets/detail/tobacco.
    1. Siddiqi K, Husain S, Vidyasagaran A, Readshaw A, Mishu MP, Sheikh A. Global burden of disease due to smokeless tobacco consumption in adults: an updated analysis of data from 127 countries. BMC Med. 2020;18:222. doi: 10.1186/s12916-020-01677-9. - DOI - PMC - PubMed
    1. Yadav A, Singh PK, Yadav N, Kaushik R, Chandan K, Chandra A, et al. Smokeless tobacco control in India: policy review and lessons for high-burden countries. BMJ Glob Health. 2020;5:e002367. doi: 10.1136/bmjgh-2020-002367. - DOI - PMC - PubMed
    1. Solberg Y, Rosner M, Belkin M. The association between cigarette smoking and ocular diseases. SurvOphthalmol. 1998;42:535–47. doi: 10.1016/s0039-6257(98)00002-2. - DOI - PubMed
    1. Elflein HM, Pfeiffer N, Hoffmann EM, Hoehn R, Kottler U, Lorenz K, et al. Correlations between central corneal thickness and general anthropometric characteristics and cardiovascular parameters in a large European cohort from the Gutenberg Health Study. Cornea. 2014;33:359–65. doi: 10.1097/ICO.0000000000000068. - DOI - PubMed

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