Background: Corneal endothelium is a sensitive structure that can be easily damaged by a wide range of insults including the phacoemulsification procedure. Diabetes mellitus negatively affect the physiology and structure of various ocular structures including cornea. The aim of this study is to evaluate the corneal endothelial alterations in diabetic and non-diabetic cataract patients after phacoemulsification and IOL implantation in Zagazig University Hospitals
Methods: A prospective study operated on total 46 patients, twenty-three patients were well-controlled type II DM patients and the other were non-diabetics. All the patients undergone uneventful phacoemulsification with IOL implantation in the bag. Specular microscopy was performed to all cases before the operation, 2 weeks, 1 month and 3 months after the operation. Collected data (ECD, CV, percentage of hexagonal cells and CCT) was statistically analyzed and presented in suitable charts and tables.
Results: The mean endothelial cell density (ECD) in diabetic group was 2687.65 ± 155.99 cell/mm2 and 2751.43 ± 152.65 cell/mm2 in non-diabetic group. After 3 months of operation, mean ECD in diabetic patients is 2272 ± 98.18 and 2438.43 ± 156.58 in non-diabetics. The difference between both groups after operation is statistically significant. The percentage reduction of ECD was 13% and 9% in diabetic and control group consecutively.
Conclusion: Despite good control of glycemic condition, corneal endothelium in diabetic patients is more vulnerable to trauma by phacoemulsification. This is reflected as increased endothelial cell loss in those patients rather than non-diabetic ones.