Corneal endothelial recovery in patients undergoing small incision cataract surgery comparison between diabetics and non diabetics. (Article)

Author

Priya Gupta (Presenting Author) [1], Pranav D More [2]

[1] Bharati Vidyapeeth Deemed University Medical College School of Optometry, Satara Road, Pune-43, Maharashtra India

[2] Medical Director Eye bank, Consultant Cornea & Refractive Services, H V Desai Eye Hospital, Hadapsar, Pune-28, Maharashtra India

Title: To assess endothelial function in diabetics and non-diabetics undergoing small incision cataract surgery.

Methods: Evaluation was performed in 20 eyes in Type II Diabetics and 20 eyes in non-diabetics who underwent uneventful small incision cataract surgery in a prospective single center study. Using a non contact specular microscope (KSS 400) central corneal thickness, corneal endothelial cell density, coefficient of variation and hexagonal cell% were measured before and at 1st day, 1st week, 1st month & 3rd month of surgery. Patients with grade II to III nuclear sclerotic age related cataract were included. Patient with past history of retinal photocoagulation, corneal pathology, contact lens wear, corneal endothelial abnormality & glaucoma were excluded.

Results: No significant differences in any preoperative measures were observed between diabetics & non-diabetics. Increase in central corneal thickness and coefficient of variation at 1st week after surgery were significantly higher in diabetics than in non-diabetics (p=0.04) and (p=0.013) respectively. However, the endothelial cell density and hexagonal cell% in diabetics were not significantly different from non-diabetics.

Conclusion: Compared with non-diabetics, diabetics showed a delayed recovery of corneal edema in the early post operative period. This suggests that eyes of diabetic patients may be under metabolic stress and have corneal endothelium with lower reserve ability than non-diabetic eyes. Therefore, assessing the corneal endothelium function in addition to the clinical examination for diabetics will provide more information about their corneal reserve and the ability of the cornea to withstand further surgical stress.

Posted by: Priya Gupta, Program Officer, India Vision Institute, India (27-Mar-2012)
F Twt G+ Li YT