Abstract
Objective:To compare the mean change in Corneal Endothelial cell Density (CED), from baseline (pre-operative value), two months after phacoemulsification cataract surgery between type II diabetic patients and non-diabetic patients.Methods:This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. 80 eyes of 72 type II diabetic patients and 80 eyes of 77 non diabetic controls, having Nuclear Opalescence (NO) grades 2 and 3 on slit lamp examination underwent phacoemulsification surgery. CED was measured in cells/mm2, of concerned eye of each subject preoperatively and 2 months post operatively using specular microscope. The difference in mean CED change between the two groups after surgery was analyzed.Results:Mean age of study population was 61.41± 6.76 years. Out of study population, 92 (57.5%) were males and 68 (42.5%) were females. There was a statistically significant difference between both groups in terms of mean post-operative CED, mean change in CED and mean frequency change in CED (p <0.05). There was no statistically significant difference between both groups in age, gender, laterality of eyes and mean pre-operative CED, (p >0.05). Difference of pre-operative CED from post-operative CED in each group was statistically significant.Conclusion:There is a significant difference between diabetic population and normal population in terms of corneal endothelial loss after uneventful phacoemulsification cataract surgery.
Highlights
Cataract is the leading cause of treatable blindness worldwide.[1]
Phacoemulsification with intraocular lens (IOL) implantation is the most common surgical procedure performed for the treatment of cataract, with benefits of causing less surgically induced astigmatism and early and better visual rehabilitation.[2,3]
The diabetic cornea suffers from cellular dysfunction and dysfunctional repair mechanisms leading to decreased corneal endothelial cell density (CED).[5]
Summary
Studies have showed that corneal endothelium of diabetic patients is more prone to damage after. Pak J Med Sci September - October 2019 Vol 35 No 5 www.pjms.org.pk 1366 cataract surgery.[2,4] The diabetic cornea suffers from cellular dysfunction and dysfunctional repair mechanisms leading to decreased corneal endothelial cell density (CED).[5] This makes cornea vulnerable to surgical insults as corneal endothelium lacks the ability to regenerate. The diabetic patients opting for cataract surgery are usually old aged and have less CED since the number of endothelial cells decreases with age. It is recommended to evaluate the corneal endothelium routinely prior to phacoemulsification, in diabetic patients.[4]
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