Evaluation Of The Corneal Endothelium Following Cataract Surgery In Diabetic And Non-Diabetic Patients

Published 2024 - 42nd Congress of the ESCRS

Reference: PO353 | Type: Poster | DOI: 10.82333/vcja-ng48

Authors: Aleksandra Opala* ¹ , Łukasz Kołodziejski ¹ , Iwona Grabska-Liberek ¹

¹Department of Ophthalmology,Centre of Postgraduate Medical Education,Warsaw,Poland

Purpose

The aim of the study is to define changes in the corneal endothelium after a phacoemulsification cataract surgery, with artificial intraocular lens implantation, in patients with type 2 diabetes (study group) as compared with patients without type 2 diabetes (control group).

Setting

The study is to compare parameters of corneal endothelium in 80 eyes (80 patients) with well-controlled type 2 diabetes and 80 eyes (80 patients) without type 2 diabetes, subject to an uneventful phacoemulsification cataract surgery.

Methods

The patients were examined at 4 time points (before the surgery, 14 days after the surgery, 3 months after the surgery and 6-8 months after the surgery). The parameters of endothelial cell density (ECD), percentage of hexagonal cells (%HEX), cell size variability (CV) and central corneal thickness (CCT) were recorded with the use of a specular microscope. Visual acuity and intraocular pressure (IOP) were measured. The cumulative dissipated energy (CDE) during phacoemulsification was recorded.

Results

Lower ECD was observed in the study group as compared to controls preoperatively, and the difference was statistically significant. ECD decline was observed in both groups postoperatively. The ECD decline presented as a percentage of the baseline measurement, was higher in the study group than in the control group. There was a statistically significant %HEX decline in both groups at any of the time points. A statistically significant increase in CV and CCT parameter was observed in both groups 14 days and 3 months after surgery. A statistically significant difference in the change of CCT was observed between the groups– the study group showed a higher increase in this parameter than the control group 14 days after surgery.

Conclusions

Endothelial cell density is lower in patients with well-controlled type 2 diabetes than in non-diabetic patients. Both well-controlled patients with type 2 diabetes and non-diabetic objects are at risk of endothelial cell loss during cataract surgery using phacoemulsification. Despite good glycemic control and no differences in parameters describing the morphology of endothelial cells before cataract surgery, the corneal endothelium of diabetic patients is more sensitive to damaging factors, and the endothelium regeneration process in this group is prolonged. The regeneration mechanisms of the corneal endothelium are impaired, which prompts the use of additional precautions during cataract surgery in this group of patients.