Endothelial cell changes after small incision cataract surgery in diabetic and non-diabetic patients: A cohort study

Cornea of diabetic patients is exposed to increased glucose concentration which contributes to the accumulation of advanced glycation end products, on the basement membrane lamina. Reduced corneal endothelial cell density and swelling of the cornea are indicators of corneal dysfunction and there is evidence that patients with diabetes mellitus have some functional corneal abnormalities. There is a paucity of data from India on the effects of small incision cataract surgery on the corneal endothelium, therefore this study will give us an insight and better understanding of the methods to adapt while operating to prevent the endothelial cell loss. Objectives: To assess the endothelial cell changes and central cornel thickness pre operatively and post operatively in patients with type II diabetes mellitus and age matched individuals after Manual Small Incision Cataract Surgery. Methods: It is a hospital based prospective cohort study done on 60 eyes of sixty diabetic patients and 60 eyes of age matched individuals who underwent small incision cataract surgery. The endothelial cell density, coefficient of variation, hexagonality and the central corneal thickness was measured at regular intervals on post operative day 1, week 1, week 4 and week 8. Results: Statistical significance in reduced ECD, increase in the coefficient of variation and central corneal thickness post operatively in diabetics when compared to age matched controls. Endothelial cell loss was independent of the duration and severity of diabetes. Conclusion: The decrease in the endothelial cell density, reflects that surgical trauma is more in diabetic patients than normal individuals.