Evaluation of corneal endothelial cell changes in diabetic patients before and after phacoemulsification surgery: A comparative study

Aim: The study was conducted to evaluate and compare the changes in corneal endothelial cell count density (ECD) and Central corneal thickness (CCT) between diabetic and non diabetic population before and after phacoemulsification surgery. Settings and Design: This prospective, comparative, interventional study was carried out at government medical college and attached group of hospitals, a tertiary eye care centre in Rajasthan, India. Materials and Methods: A total of 50 patients with type II diabetes mellitus (age group 30-80 years) and 50 age matched healthy patients of senile cataract with clear cornea without any other ocular pathology were non-randomly selected for Phacoemulsification surgery (phaco) after detailed preoperative assessment. All patients were operated by the same surgeon with phaco chop technique to exclude any surgeon's related bias. Endothelial cell count, CCT and Coefficient of Variance (CV) was measured with specular microscope pre-operatively and postoperatively at day 1st, 7th, 15th, 1 month, and 3 months serially. Result: Postoperatively, the mean ECD was decreased in both the groups but loss of endothelial cell count was significantly more in diabetic population as compare to non diabetic groups at day 1, day 7, day 15, 1 month and 3 months. CCT was increased on first post-operative day in both the groups, subsequently decreased and then returned back to about same as pre-operative state after 1 month. But postoperatively, the change in mean CCT was not significant between both groups. The difference in % CV was significantly higher in diabetic group as compared to non diabetic group postoperatively. Conclusion: The corneal endothelial cell changes were significantly high in diabetic population as compared to nondiabetic patients. The ECD loss, increase in mean CCT and % CV were more in diabetic population as compared to non diabetic. And patients with diabetes showed slower recovery in endothelial healing as compared to non diabetic group.