Corneal Endothelial Cell Density Changes In Diabetic And Non-Diabetic Eyes In Grade 2 And Grade 3 Nuclear Sclerosis Undergoing Phacoemulsification

Corneal Endothelial Cell Density Changes In Diabetic And Non-Diabetic Eyes

Abstract

Background: Corneal endothelial cells are susceptible to mechanical trauma from ultrasound energy during phacoemulsification. Several studies have reported various results of phacoemulsification effect on corneal endothelial cells between diabetic and non-diabetic patients due to stressful events. Present study was aimed to evaluate corneal endothelial density, hexagonality and Central Corneal Thickness (CCT) changes between diabetic and non-diabetic patients at early postoperative period and 1 month after phacoemulsification. Material And Methods: Specular microscopy examinations prior to phacoemulsification and at early postoperative period and 1 months after phacoemulsification were performed on diabetic and non-diabetic groups in grade 2 and grade 3 nuclear sclerosis. Later the changes in endothelial density, the percentage of hexagonality, and Central corneal thickness were evaluated. Result: Mean age of 120 study sample was 58.45 years (standard deviation – 8.498 years), with the highest 74 years and lowest 43 years. There were 53 (44%) females and 67 (56%) males in the study. 42 (35%) samples were from 51-60 years age group followed by 37 (30.83%) subjects in 61-70 years age group. Mean corneal endothelial cell density decreases after cataract surgery in comparison with pre-operative density among study samples. Mean pre-operative corneal endothelial cell density was lower in diabetics in comparison with non-diabetics, and the difference was statistically significant. Cell density count decreases after cataract surgery in both groups with significant difference between two groups. Mean corneal endothelial cell morphology (hexagonal cell percentage) decreases after cataract surgery in comparison with pre-operative density among study samples. Central corneal thickness increases in early postoperative period followed by normalisation at day 30. Conclusion: Diabetic group showed greater hexagonality decrease compared to non-diabetic group at 1 month after phacoemulsification. It is suggested that diabetic corneal endothelium requires additional care and protective measures during cataract surgery to minimize surgical trauma. There were no statistically significant differences in the endothelial loss and Central corneal thickness changes between the diabetic and non-diabetic group at 1 month follow up after phacoemulsification. [Sarate K Natl J Integr Res Med, 2022; 13(1): 16 -22, Published on 26/01/2022]