Changes in Corneal Endothelium after Phacoemulsification in Diabetic and Non-diabetic Cataract Patients in Zagazig University Hospitals

Abdeen, Adel; Hanifa, Hassan; Awad, Azza S.; Ahmed, Hussein

doi:10.21608/zumj.2020.44499.1959

Cited by 1 publication

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“…They concluded that the cornea in patients with diabetes is more vulnerable to stress and trauma, which leads to more ECD loss despite good glycemic control. Contrary to Abdeen et al [14], who found significant endothelial cell loss in the diabetic group at 2 weeks, 1 month, and 3 months postoperatively, we found no significant differences between the non-diabetic and diabetic group at 1, 3, and 6 months postoperatively. A possible reason for the difference between the two studies could be the greater CDE with prolonged phaco time for the harder nuclear cataracts graded as NII and NIII in the study by Abdeen et al [14], while we had lower CDE with shorter phaco time for the less hard nuclear cataracts graded as NI or NII.…”

Section: Discussioncontrasting

confidence: 99%

“…Abdeen et al [14] compared the change in mean ECD at 3 months after phacoemulsification in 23 eyes of patients with well-controlled T2 DM versus 23 eyes of non-diabetic participants. Their inclusion criteria were comparable to those of the current study, except that they operated grades NII and NIII senile nuclear cataracts, while we included only grade NI or NII to allow better visualization and good macular OCT imaging.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of phacoemulsification on the corneal endothelium in diabetic versus non-diabetic patients: a prospective non-randomized controlled interventional study

Mahmoud¹,

Moussa²,

Abozaid³

et al. 2021

Med Hypothesis Discov Innov Optom

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Background: Cataract surgery in patients with diabetes is indicated either to improve visual acuity or to allow assessment and treatment of fundus changes. We aimed to document the effects of phacoemulsification on the corneal endothelium in patients with or without diabetes. Methods: This comparative, prospective, non-randomized controlled interventional study was conducted in patients with visually significant immature senile cataracts in the ophthalmology department at Sohag University Hospital between January 2018 and December 2020. The following data were recorded: corrected distance visual acuity, keratometry readings, refraction, slit lamp examination results, and biometry data. Changes in corneal parameters were documented preoperatively and at 1, 3, and 6 months postoperatively using specular microscopy. Results: Sixty-four eyes of 64 patients with visually significant senile cataracts were included (32 eyes in the diabetic group and 32 eyes in the non-diabetic control group). We found greater mean endothelial cell loss in the non-diabetic group (179 cells/mm2; 6.4%) than in the diabetic group (134 cells/mm2; 4.8%) at 3 months postoperatively, yet the difference was not significant. The difference could be explained by the higher mean cumulative dissipated energy (CDE) used in the non-diabetic group (5.37 J) than in the diabetic group (4.68 J), although the difference was also not significant. Moreover, we found significantly higher coefficient of variation (CV) in the non-diabetic group than in the diabetic group at 1, 3, and 6 months postoperatively (P = 0.03, P = 0.02, and P = 0.008, respectively). Conclusions: Endothelial cell density was directly related to the CDE of phacoemulsification and not to diabetes. CV was significantly higher in the non-diabetic group than in the diabetic group. Future studies with a larger sample size, longer follow-up, and more diabetic subgroups with different levels of glycemic control are warranted to verify our conclusions. How to cite this article: Mahmoud A, Moussa I, Abozaid M, Iqbal M. Outcomes of phacoemulsification on the corneal endothelium in diabetic versus non-diabetic patients: a prospective non-randomized controlled interventional study. Med Hypothesis Discov Innov Optom. 2021 Spring; 2(1): 1-7. DOI: https://doi.org/10.51329/mehdioptometry119

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%