Comparison of Endothelial Cell Density Post- Phacoemulsification between Diabetic and Non- Diabetic Patients

Abstract

Objective: To compare the corneal endothelial cell density (CED) after phacoemulsification for cataract surgery between type II diabetic patients and non-diabetic patients.

Methodology: This comparative cross-sectional study was conducted at Sindh Institute of Ophthalmology and Visual Sciences, Hyderabad, from August 2021 to January 2022. Patients aged between 35 and 60 years, both genders presented with cataract of any duration and undergoing uneventful phacoemulsification cataract surgery were included. One day before phacoemulsification, CED was measured using by Topcon SP 3000P Specular Microscope. During surgery, total operative time, pre-operative CED and post- operative CED were measured. Patients were reviewed postoperatively to measure CED after 1 week through a pre-designed proforma.

Results: There were 279 patients enrolled in the study. The mean corneal endothelial cell density pre- operatively was noted 2522.22 ± 181.59 cells/mm² which was post significantly decreased as 1702.00 ± 73.56 cells/mm² (p=0.001). Most importantly, the mean post-operative CED was significantly lower among diabetes patients (1671.96 ± 48.64 cells/mm²) compared to non-diabetics (1840.09 ± 81.91 cells/mm²), (p = 0.001), indicating significant more endothelial cell loss after surgery, among diabetic patients.

Conclusion: Diabetic patients observed with significantly more CED loss following phacoemulsification compared to non-diabetic cases, expected due to the prolonged structural and metabolic alterations in the corneal endothelium resulting from chronic hyperglycemia.