Comparison of Corneal Endothelial Cell Parameters between Diabetic and Non-Diabetic Patients after Phacoemulsification Cataract Surgery
DOI:
https://doi.org/10.70749/ijbr.v3i6.2901Keywords:
Diabetes mellitus, corneal endothelium, diabetic and non-diabetic, phacoemulsification cataract surgery, Careful surgical planning.Abstract
Background: Diabetes mellitus is associated with structural and functional alterations of the corneal endothelium, potentially increasing the risk of endothelial damage following cataract surgery. Phacoemulsification, although widely performed and considered safe, may result in significant endothelial cell loss, particularly in diabetic patients. Objective: To assess and compare corneal endothelial cell changes after phacoemulsification cataract surgery in diabetic and age-matched non-diabetic patients. Methods: The study was a prospective descriptive cross-sectional study that was carried out at Al-Shifa Trust Eye Hospital, Rawalpindi, during a period of six months (from August 2024 to February, 2025). There were 94 patients (47 diabetics and 47 non-diabetics) who were undergoing uneventful phacoemulsification. The parameters of preoperative and postoperative endothelial corneal parameters were evaluated through specular microscopy of endothelial cell density (ECD), hexagonality, coefficient of variation (CV) and central corneal thickness (CCT) in the preoperative, 1 and 4 weeks postoperative assessments. The SPSS version 23 was used to analyze data. In places where it was suitable, independent samples t-test and chi-square test were used. The p-value of less than 0.05 was taken as statistically significant. Results: Preoperatively, diabetic patients had significantly lower ECD and hexagonality, along with higher CV and CCT compared to non-diabetics (p < 0.05). Postoperatively, endothelial cell density was significantly lower in diabetic patients at both 1 week and 4 weeks (p = 0.001). Percentage endothelial cell loss was significantly greater in diabetics at both time points. Conclusion: Diabetic patients exhibit greater endothelial vulnerability following phacoemulsification cataract surgery, even with good glycemic control. Careful surgical planning and close postoperative monitoring are recommended in this population.
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1. Chaurasia, R.K., A. Khasnavis, and J.J.I.J.o.O. Mittal, Comparison of corneal endothelial changes following phacoemulsification in diabetic and non-diabetic patients. 2022. 70(4): p. 1208-1213.
https://doi.org/10.4103/ijo.ijo_1955_21
2. Budiman, B.J.T.o.o.j., Comparison of endothelial cell density, morphological changes and central corneal thickness after phacoemulsification between diabetic and non-diabetic patients. 2020. 14(1).
https://doi.org/10.2174/1874364102014010015
3. Mahmoud, A., et al., Outcomes of phacoemulsification on the corneal endothelium in diabetic versus non-diabetic patients: a prospective non-randomized controlled interventional study. 2021. 2(1): p. 1-7.
https://doi.org/10.51329/mehdioptometry119
4. Beato, J.N., et al., Corneal structure and endothelial morphological changes after uneventful phacoemulsification in type 2 diabetic and nondiabetic patients. 2021. 84: p. 454-461.
https://doi.org/10.5935/0004-2749.20210071
5. Rathi, V., T. Shakeel, and S.J.C.I.E.R. Dasgupta, Corneal endothelial changes after phacoemulsification among type 2 diabetic and non-diabetic patients in an Indian population. 2021. 8: p. 39-44.
6. Lasrado, A.S., Comparative Study on Corneal Endothelial Cell Changes After Small Incision Cataract Surgery in Diabetic and Non-Diabetic Age Matched Population-A Prospective Study. 2020, Rajiv Gandhi University of Health Sciences (India).
7. Sowmya, C., Comparative Study Of Outcome Of Cataract Surgery In Diabetic And Non Diabetic Patients. 2020, BLDE (Deemed to be University).
https://doi.org/10.18231/j.ijceo.2020.037
8. Shaheed, M.M., et al., A Comparative Evaluation of Corneal Endothelium between Diabetic & Non-Diabetic Patients Undergoing Phacoemulsification in a Tertiary Hospital. 2022. 5(2): p. 9-15.
https://doi.org/10.3329/jnio.v5i2.66785
9. Kang, K.H., et al., Corneal endothelial cell changes after femtosecond laser–assisted cataract surgery in diabetic and nondiabetic patients. 2021. 47(12): p. 664-669.
https://doi.org/10.1097/icl.0000000000000823
10. Sekelj, S., et al., Corneal edema recovery after phacoemulsification in type 2 diabetic versus non-diabetic patients. 2021. 10(1): p. 144-148.
https://doi.org/10.5603/dk.a2021.0003
11. SAIF, M.Y.S.J.N.j.f.G. and Gerontology, Central corneal thickness before and after phacoemulsification in non-diabetic and diabetic patients without retinopathy. 2020. 3(Geriatric ophthalmology): p. 15-22.
12. Elminshawy, A.I., H.S. Hegazy, and M.M.J.A.-A.A.M.J. Aly, Comparison of corneal changes after phacoemulsification in diabetic and nondiabetic eyes. 2022. 20(1): p. 134-141.
https://doi.org/10.4103/azmj.azmj_130_21
13. Sarate, K.M., D.B. Rathod, and H.D.J.N.J.o.I.R.i.M. Sahare, Corneal Endothelial Cell Density Changes In Diabetic And Non-Diabetic Eyes In Grade 2 And Grade 3 Nuclear Sclerosis Undergoing Phacoemulsification. 2022. 13(1).
14. Kudva, A.A., et al., Corneal endothelial cell changes in diabetics versus age group matched nondiabetics after manual small incision cataract surgery. 2020. 68(1): p. 72-76.
https://doi.org/10.4103/ijo.ijo_406_19
15. Pardasani, R., S.J.J.o.E.o.M. Lohiya, and D. Sciences, Study of changes in corneal thickness and corneal endothelial cell density after phacoemulsification cataract surgery. 2021. 10(12): p. 866-873.
https://doi.org/10.14260/jemds/2021/187
16. Erfan, M.B.A.H., et al., Evaluation of the Corneal Thickness and Endothelial Changes Following Uncomplicated Phacoemulsification in Diabetic and Non-Diabetic Patients by Pentacam and Specular Microscopy. 2020. 79(1): p. 489-496.
https://doi.org/10.21608/ejhm.2020.82462
17. Azhan, A., et al., Comparison of VEGF level in tears post phacoemulsification between non-proliferative diabetic retinopathy and non-diabetic patients. 2021. 20(2): p. 2073-2079.
https://doi.org/10.1007/s40200-021-00875-3
18. Bansal, A. and M.J.I.J.A.M.P. Bansal, A Comparative Study Of Cataract Surgery In Diabetic And Non-Diabetic Patients. 2022. 4(5): p. 652-655.
19. Beato, J.N., et al., Alterações da estrutura e endotélio da cornea após facoemulsificação sem complicações em pacientes diabéticos tipo 2 e não diabéticos. 2021. 84(5): p. 454-461.
20. Sarkar, S.J.E.J.o.C.M., Comparative study of outcome of cataract surgery in diabetic and non-diabetic patients. 2020. 10: p. 37-39.
https://doi.org/10.18231/j.ijceo.2020.037
21. Abdelfatah, R.F., et al., The effect of phacoemulsification on corneal endothelial cells morphology and thickness. 2020. 36(4).
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