Meta-Analysis on Corneal Changes Following Phacoemulsification in Diabetic vs. Non-Diabetic Cataract Patients

Abstract

Aim of the Study: was to investigate the influence of phacoemulsification on corneal endothelial cells and its injury risk factors in diabetic cataract patients and non-diabetic patients. Methods: electronic databases were searched: Scopus, EMBASE, and Google Scholer), PubMed/MEDLINE, Scopus, The Cochrane Library, and Web of Science. Econlit from 1990 to 2017. This was completed with a manual search of references of relevant papers. Risk of bias in methodology of studies was measured using the Newcastle-Ottawa Scale. Results: Observation of corneal endothelial cell density, coefficient of variation and percentage of hexagonal cells preoperatively, 1 day, 1week, 1 and 3 months postoperatively was carried out, and multiple Logistic regression analysis for risk factors of corneal endothelial cell injury was taken. Results: Out of 779 retrieved papers, 9 studies with a total of 1129 individuals were finally included (579 diabetic eyes and 550 non-diabetic eyes). For the dynamic changes between preoperative and postoperative values, significant differences were identified between the two groups in endothelial cell density (ECD) and hexagon cells (HC%) at 1 day, 1 week, 1 month, and 3 months postoperatively, in central corneal thickness (CCT) at 1 month postoperatively, and in coefficient variation (CV) at 1 week and 1 month postoperatively. However, no significant differences were observed in CCT at 1 day, 1 week and 3 months postoperatively or in CV at 1 day and 3 months postoperatively. Conclusion: it could be concluded from the current literature that aged-cataract patients with diabetes mellitus manifested poor tolerability to cataract phacoemulsification surgery in contrast to senile cataract patients.