Endothelial changes in patients with and without diabetes after manual small-incision cataract surgery

Abstract

Background and objective

In Mexico there is a high prevalence of diabetes, which is one of the most frequent etiologies of cataract. The impact of diabetes on postoperative corneal decompensation associated with MSICS has not been studied in our country. The objective of the study was to determine the difference in corneal endothelial changes between diabetic and non-diabetic patients by preoperative specular microscopy and at one month and 3 months after MSICS.

Patients and methods

Prospective, longitudinal, paired, non-randomized study with two groups; Group 1: diabetic patients and Group 2: non-diabetic patients. All patients had a complete ophthalmologic evaluation and preoperative and postoperative specular microscopy at one month and 3 months.

Results

119 eyes were included. The percentage of CD loss at 1 month was 11.1% in diabetic patients and 6.3% in non-diabetic patients. At 3 months the percentage of loss was 9.9% in diabetic patients and 5.4% in non-diabetic patients. The CV was higher in patients with diabetes and was significant at 1 month; however, at 3 months the values ​​were comparable. The percentage of HEX decreased significantly in the first month in patients with diabetes.

Conclusions

There was a significant difference with greater CD loss, greater CV and less HEX in patients with diabetes vs. without diabetes at 1 month after the M-SICS procedure, however, it was not statistically significant at 3 months. This suggests greater endothelial stress, longer recovery time and remodeling of the corneal endothelium in patients with diabetes.