Changes of corneal endothelium cells following 23 gauge vitrectomy in diabetic retinopathy patients

Abstract

Background 23G pars plana vitrectomy has been widely applied to treat diabetic retinopathy(OR). Researching the influence of 23G pars plana vitrectomy on corneal endothelium cell has a great clinical significance. Objective To observe the influence of 23G pars plana vitrectomy on corneal endothelial cells in phakic eyes of diabetes and non-diabetes patients. Methods A retrospective study was designed.One hundred and twenty-four eyes of 124 patients with vitreoretinopathy were included in Affiliated Hospital of Qingdao University from August 2012 to June 2013.The patients were assigned to DR group (52 eyes) and non-DR group (72 eyes).23G pars plana vitrectomy was performed on all the patients under their informed consent.Endothelial cell density, corneal thickness(CT), coefficient of variation(CV) of cellular area, standard deviation(SD) of average cellular area and percentage of hexagonal endothelial cells were measured before and 1 day, 3 days, 1 week, 2 week, 1 month and 3 months after surgery with Topcon SP-3000P corneal specular microscope. Results No significant differences were found in the central corneal endothelial cell density between the DR group and non-DR group at various time points (Fgroup=2.148, P=0.150; Ftime=0.900, P=0.504). The CV of endothelial cells, SD of endothelial cellular area and CT in the first day after surgery were higher than preoperation (P=0.000, 0.011, 0.033), while the percentage of hexagonal endothelial cells was declined (P=0.001). The CV of endothelial cells and the percentage of hexagonal endothelial cells recovered in postoperative 1 month in the DR group.In the non-DR group, the CV of endothelial cells and CT elevated in postoperative 1 day in comparison with preoperation (P=0.002, 0.003), and the percentage of hexagonal endothelial cells reduced (P=0.000). These abnormalities returned to a preoperative level in a week after surgery. Conclusions 23G pars plana vitrectomy results in a reversible morphology damage of corneal endothelial cells.These damage may be more severe with a longer duration in DR patients compared with non-DR patients. Key words: Vitrectomy/complication; Endothelium, corneal; Diabetic retinopathy/surgery; Retrospective study