Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study
Introduction: Diabetes Mellitus (DM) has emerged as a significant cause of ocular morbidity. The toxic effects of hyperglycaemia spare no cell in the body and cornea, has also revealed certain changes in diabetic patients. Higher phacoemulsification time and power effect corneal endothelial cell...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-07-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18197/53735_CE[Ra1]_F(KM)_PF1(HB_SHU_KM)_PFA(HB_KM)_PN(KM).pdf |
| _version_ | 1797769999393226752 |
|---|---|
| author | Hans Raj Sharma Anureet Kaur Ashok K Sharma Asma Jabeen Rohini Choudhary |
| author_facet | Hans Raj Sharma Anureet Kaur Ashok K Sharma Asma Jabeen Rohini Choudhary |
| author_sort | Hans Raj Sharma |
| collection | DOAJ |
| description | Introduction: Diabetes Mellitus (DM) has emerged as a significant
cause of ocular morbidity. The toxic effects of hyperglycaemia
spare no cell in the body and cornea, has also revealed certain
changes in diabetic patients. Higher phacoemulsification time
and power effect corneal endothelial cells. This can inflict an
additional stress on the altered diabetic corneal endothelium.
Aim: To compare the Central Corneal Thickness (CCT)
thickness and endothelial Cell Density (CD) and morphology
in Type 2 Diabetes Mellitus (T2DM) patients undergoing
phacoemulsification with age-matched non diabetic controls
undergoing phacoemulsification.
Materials and Methods: A prospective, hospital-based,
interventional study was conducted in the Department of
Ophthalmology, Government Medical College, Jammu, Jammu
and Kashmir, India. The duration of the study was nine months,
from April 2021 to December 2021. The study included 50
patients with T2DM and 50 non diabetic controls. All patients
underwent phacoemulsification performed by a single surgeon.
The CCT and endothelial cell parameters were measured
preoperatively and postoperatively at one week, six weeks and
three months using Topcon specular microscope. Postoperative
changes in the corneal endothelial cells were compared between
the two groups for a period of three months. Statistical analysis
was done by using the Statistical Package for Social Sciences
(SPSS) version 25.0 (IBM Corp. Released 2017. Armonk, NY,
USA). Categorical variables were analysed using Chi-square
test and the groups were compared using Student’s t-test.
Results: The mean age of the study participants was 63.22±7.52
years in diabetic group and 64.52±7.29 years in non diabetic group.
Diabetic patients showed significantly greater corneal thickness than
non diabetic controls (p=0.034). This pattern was observed till the
last follow-up at three months. The endothelial cell parameters were
comparable between diabetic and non diabetic patients. There was
a fall in endothelial cell count in all patients postoperatively, but it was
significantly higher in the diabetic patients at three months (p=0.048).
Postoperatively, Co-efficient of Variation (CV) was significantly
higher in diabetic patients (p=0.001) accompanied by a decreased
hexagonality (p=0.039) at the end of three months.
Conclusion: A diabetic cornea is different than a non diabetic
cornea at the cellular level. Diabetics show accelerated corneal
endothelial cell loss and greater variation in cell morphology in
response to surgical stress. Diabetes mellitus is a risk factor for
endothelial cell loss in patients undergoing cataract surgery. |
| first_indexed | 2024-03-12T21:16:09Z |
| format | Article |
| id | doaj.art-ad942785c1454066bb2660822dc404bb |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-12T21:16:09Z |
| publishDate | 2023-07-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-ad942785c1454066bb2660822dc404bb2023-07-29T10:54:30ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-07-01177050810.7860/JCDR/2023/53735.18197Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective StudyHans Raj Sharma0Anureet Kaur1Ashok K Sharma2Asma Jabeen3Rohini Choudhary4Associate Professor, Department of Ophthalmology, Government Medical College, Jammu, Jammu and Kashmir, India.Resident, Department of Ophthalmology, Government Medical College, Jammu, Jammu and Kashmir, India.Professor, Department of Ophthalmology, Government Medical College, Jammu, Jammu and Kashmir, India.Resident, Department of Ophthalmology, Government Medical College, Jammu, Jammu and Kashmir, India.Resident, Department of Ophthalmology, Government Medical College, Jammu, Jammu and Kashmir, India.Introduction: Diabetes Mellitus (DM) has emerged as a significant cause of ocular morbidity. The toxic effects of hyperglycaemia spare no cell in the body and cornea, has also revealed certain changes in diabetic patients. Higher phacoemulsification time and power effect corneal endothelial cells. This can inflict an additional stress on the altered diabetic corneal endothelium. Aim: To compare the Central Corneal Thickness (CCT) thickness and endothelial Cell Density (CD) and morphology in Type 2 Diabetes Mellitus (T2DM) patients undergoing phacoemulsification with age-matched non diabetic controls undergoing phacoemulsification. Materials and Methods: A prospective, hospital-based, interventional study was conducted in the Department of Ophthalmology, Government Medical College, Jammu, Jammu and Kashmir, India. The duration of the study was nine months, from April 2021 to December 2021. The study included 50 patients with T2DM and 50 non diabetic controls. All patients underwent phacoemulsification performed by a single surgeon. The CCT and endothelial cell parameters were measured preoperatively and postoperatively at one week, six weeks and three months using Topcon specular microscope. Postoperative changes in the corneal endothelial cells were compared between the two groups for a period of three months. Statistical analysis was done by using the Statistical Package for Social Sciences (SPSS) version 25.0 (IBM Corp. Released 2017. Armonk, NY, USA). Categorical variables were analysed using Chi-square test and the groups were compared using Student’s t-test. Results: The mean age of the study participants was 63.22±7.52 years in diabetic group and 64.52±7.29 years in non diabetic group. Diabetic patients showed significantly greater corneal thickness than non diabetic controls (p=0.034). This pattern was observed till the last follow-up at three months. The endothelial cell parameters were comparable between diabetic and non diabetic patients. There was a fall in endothelial cell count in all patients postoperatively, but it was significantly higher in the diabetic patients at three months (p=0.048). Postoperatively, Co-efficient of Variation (CV) was significantly higher in diabetic patients (p=0.001) accompanied by a decreased hexagonality (p=0.039) at the end of three months. Conclusion: A diabetic cornea is different than a non diabetic cornea at the cellular level. Diabetics show accelerated corneal endothelial cell loss and greater variation in cell morphology in response to surgical stress. Diabetes mellitus is a risk factor for endothelial cell loss in patients undergoing cataract surgery.https://www.jcdr.net/articles/PDF/18197/53735_CE[Ra1]_F(KM)_PF1(HB_SHU_KM)_PFA(HB_KM)_PN(KM).pdfcataract surgerycorneaocular morbidityhyperglycaemia |
| spellingShingle | Hans Raj Sharma Anureet Kaur Ashok K Sharma Asma Jabeen Rohini Choudhary Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study Journal of Clinical and Diagnostic Research cataract surgery cornea ocular morbidity hyperglycaemia |
| title | Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study |
| title_full | Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study |
| title_fullStr | Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study |
| title_full_unstemmed | Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study |
| title_short | Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study |
| title_sort | central corneal thickness and endothelial cell changes after phacoemulsification in patients with diabetes mellitus a prospective study |
| topic | cataract surgery cornea ocular morbidity hyperglycaemia |
| url | https://www.jcdr.net/articles/PDF/18197/53735_CE[Ra1]_F(KM)_PF1(HB_SHU_KM)_PFA(HB_KM)_PN(KM).pdf |
| work_keys_str_mv | AT hansrajsharma centralcornealthicknessandendothelialcellchangesafterphacoemulsificationinpatientswithdiabetesmellitusaprospectivestudy AT anureetkaur centralcornealthicknessandendothelialcellchangesafterphacoemulsificationinpatientswithdiabetesmellitusaprospectivestudy AT ashokksharma centralcornealthicknessandendothelialcellchangesafterphacoemulsificationinpatientswithdiabetesmellitusaprospectivestudy AT asmajabeen centralcornealthicknessandendothelialcellchangesafterphacoemulsificationinpatientswithdiabetesmellitusaprospectivestudy AT rohinichoudhary centralcornealthicknessandendothelialcellchangesafterphacoemulsificationinpatientswithdiabetesmellitusaprospectivestudy |