gms | German Medical Science

Introduction: Corneal endothelial cells have a very limited regenerative potential. This can additionally be influenced in a negative way in patients with type 2 diabetes.

Purpose: To compare the difference in endothelial cell density (ECD) changes in diabetic and non-diabetic patients before and after uncomplicated cataract surgery.

Methods: A total of 41 patients (22 diabetics and 19 non diabetics), aged 72.2±3.6, 21 female and 20 male with age-related cataract underwent standard phacoemulsification with IOL implantation through a 2.2 mm clear corneal incision. The selected diabetic and non-diabetics cases did not differ in total ultrasound time, phacoemulsification amplitude, aspiration time or fluid usage. The ECD was examined with specular microscopy (Perseus, CSO) preoperatively and 4 weeks postoperatively. Statistical analysis was performed at the level of statistical significance of p<0.05.

Results: The mean pre-operative ECD in the control was higher than the diabetic group (p<0.01). Both groups demonstrated a statistically significant postoperative endothelial count loss (p<0.01). When comparing the post-operative endothelial cell loss in non-diabetics (7.75%) to diabetic group, the diabetic group had significantly higher endothelial loss (14.94%, p<0.01).

Conclusion: Compared to non-diabetic, diabetic patients have more endothelial cell damage at 1 month after phacoemulsification. The evaluation of corneal endothelial cell density, especially in diabetic patients, is recommended before any cataract surgery.

Keywords: Endothelial cell count, ECD, cataract, diabetes