Corneal Endothelium Evaluation Post Phacoemulsification Among Diabetic Patients In Saudi Arabia
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT301 | Type: Poster | DOI: 10.82333/d6ns-4p97
Authors: Dr Omar AL Sowayigh* 1 , Dr Nawaf AL Ghamdi 2 , Mr Shahid Khan 1 , Mr Abdullah AL Dahman 1 , Dr Turki AL Ghamdi 1
1Ophthalmology,Armed Forces Hospital Southern Region,Khamis Mushait,Saudi Arabia, 2King Saud University,Riyadh,Saudi Arabia
Purpose
To evaluate and compare corneal endothelial health following cataract phacoemulsification in diabetic and nondiabetic Saudi patients using specular microscopy.
Setting
A single-center prospective cohort study conducted at a tertiary hospital in Saudi Arabia.
Methods
This prospective cohort study included 180 Saudi patients (100 with diabetes and 80 nondiabetic controls) who underwent uneventful phacoemulsification with intraocular lens implantation. One eye per patient was analyzed. Endothelial parameters—endothelial cell density (ECD), coefficient of variation (CV), hexagonal cell percentage (HEX), and central corneal thickness (CCT)—were measured using non-contact specular microscopy at the preoperative and postoperative (1 and 4 weeks) periods. HbA1c levels were measured preoperatively to assess glycemic control.
Results
Preoperative endothelial parameters showed no significant differences between the diabetic and nondiabetic groups. Postoperatively, both groups demonstrated a statistically significant decrease in ECD (p<0.001), increase in CCT (p<0.001), and reduction in HEX (p<0.05), but with no significant differences between the diabetic and nondiabetic groups. Among the measured endothelial parameters, glycemic control status did not significantly affect postoperative outcomes. No patient developed corneal decompensation or pseudophakic bullous keratopathy during the follow-up period.
Conclusions
Within a population characterized by a high prevalence of both cataract and diabetes, our study of Saudi patients found that phacoemulsification surgery induces measurable corneal endothelial trauma in both diabetic and nondiabetic patients. Diabetes—regardless of glycemic control—had no significant impact on endothelial outcomes, suggesting that surgical trauma may be the primary determinant of adverse endothelial changes. Nevertheless, the potential susceptibility of diabetic patients to phacoemulsification surgery damage may warrant more careful preoperative evaluation and tailored surgical planning to ensure optimal outcomes.