CORNEAL ENDOTHELIAL CELL LOSS AFTER SMALL INCISION CATARACT SURGERY IN DIABETIC VERSES NON DIABETIC PATIENTS
Abstract
Rationale : This study was undertaken to assess the postoperative endothelial cell loss, change in endothelial cell morphology and central corneal thickness in patients with type II diabetes undergoing manual SICS and to compare them with age-matched normal individuals.
Method: The present study is a prospective, comparative study carried out at a tertiary care hospital which aims to assess and compare the endothelial cell loss and changes in central corneal thickness after manual small incision cataract surgery in patients with type II diabetes versus age-matched normal individuals.
Result: A total of 100 eyes of 100 individuals with type II diabetes and 100 eyes of 100 age matched normal individuals in the age group of 50-80 years were studied The endothelial cell loss at 3 months in cases was 22.01 ± 10.49% and in controls was 16.64 ± 6.72% with a significant difference indicating increased vulnerability of corneal endothelium in diabetics to intraocular surgical stress.
• Coefficient of variation of cell size and percentage of hexagonal cells, being indicators of repair after cataract surgery were not found to be significantly different in cases and controls.
• Central corneal thickness was maximum at the first follow up at 2 weeks in both the groups, and then gradually decreased. CCT was significantly raised in diabetics in all the follow-ups indicating a slower resolution of postoperative corneal edema in diabetics.
Conclusion: Postoperatively, there was a significant endothelial cell loss between cases and controls at 3 months. Therefore, in spite of a good glycemic control and no corneal abnormalities before surgery, the endothelium in diabetic subjects was found to be more vulnerable to surgical trauma and also having a lower capability in the process of repair. This suggests that eyes of diabetic patients are under metabolic stress and have corneal endothelium with lower reserve ability than non diabetic eyes. Therefore, surgery should be planned with appropriate precautions in diabetic patients.
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References
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