Purpose: To determine whether phacoemulsification with intraocular lens implantation has a greater impact on the corneal endothelium of type 2 diabetic patients compared to non-diabetic patients.
Materials and methods: This study compared the endothelial status in 32 diabetics with good glycemic control and 32 non-diabetic patients before and after uneventful phacoemulsification. Central corneal thickness (CCT), central corneal endothelial cell density (CD), hexagonal cell percentage (HEX), and percent coefficient of variation (% CV) were measured using a specular microscope.
Results: Data were matched by age and sex. Diabetics showed a significantly higher loss of endothelial cells compared to non-diabetics. After 3 months, there was a decline of 165 endothelial cells (SD 97) in the diabetic group and 114 (SD 45) in the control group. This was statistically significant (P=0.0065). In addition, diabetics showed a slower recovery trend of endothelial healing as evidenced by a lower CV variation. The CV change was 4.7 in the control group and 3.2 in the diabetic group, which was statistically significant (P=0.023). A significant correlation was found between the energy used and the change in endothelial count as well as the CV in both groups.
Conclusion: Despite good glycemic control, diabetics have significantly more endothelial damage compared to non-diabetics with a similar nuclear classification and phacoemulsification energy used. This justifies a more careful use of phacoemulsification energy in diabetics.
Keywords: Central corneal thickness; Coefficient de variation; Coefficient of variation; Comptage des cellules endothéliales; Corneal endothelial cell count; Pachymétrie cornéenne centrale; Percentage hexagonality; Pleomorphism; Pléomorphisme; Pourcentage des cellules hexagonales.
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