Evaluation of the Corneal Thickness and Endothelial Changes Following Uncomplicated Phacoemulsification in Diabetic and Non-Diabetic Patients by Pentacam and Specular Microscopy

Abstract

Background: Diabetes mellitus (DM) is an important health problem that induces unrestful complications. It causes significant morbidity owing to specific microvascular complications such as diabetic retinopathy, diabetic cataract, diabetic keratopathy, and diabetic optic nerve diseases. Patients and Methods: This is a prospective, comparative case series study assessing the corneal endothelial status in 20 diabetics and 20 non diabetics before, after 1 day, 1 week and 1 month of uneventful phacoemulsification using phaco-chop technique. Central corneal thickness (CCT), as well as endothelial cell density (ECD), coefficient of variation (CV) and percentage of polymegathism or hexagonality were measured by specular microscopy. The corneal thickness at 0, 2 and 4 mm from center of the cornea and corneal volume at 3, 5 and 7 mm from the center of the cornea. Changes were compared between both groups using pentacam in the same follow up period. Results: Preoperative CCT was found to be significantly higher in diabetic than in non-diabetic group. ECD and CV were insignificantly higher in diabetics in contrast with the percentage of hexagonality, which was found to be insignificantly lower preoperatively. Diabetics showed insignificant higher loss in endothelial cell count as compared to non-diabetics. Furthermore, the diabetics showed a slower recovery trend in the endothelial healing response as evidenced by lower change in the CV%. Postoperative CCT measurements demonstrated no significant variations between groups evidenced by specular microscopy as well as changes in corneal thickness and volume evidenced by pentacam. Conclusion: The present study revealed no significant differences between preoperative and postoperative values neither in terms of mean ECD values, nor in corneal thickness and corneal volume between diabetic patients and nondiabetic patients undergoing phacoemulsification employing phaco-chop technique.