The influence of phacoemulsification on corneal endothelial cells at varying blood glucose levels.

PURPOSE: To investigate the influence of phacoemulsification on corneal endothelial cells in diabetes patients and normal controls.

METHODS

Phacoemulsification and intraocular lens implantation were performed on 75 patients with diabetic cataract (126 eyes) who were divided into two groups: Experimental group 1 (Glu ≤ 6mmol/L); Experimental group 2 (Glu 6-10 mmol/L) and 65 non-diabetic controls (112 eyes). The density and percentage of hexagonal cells and coefficient of variation of the corneal endothelia were measured before surgery and 1 day, 1 month and 3 months postoperatively.

RESULTS

There was no statistical difference in the density and percentage of hexagonal cells and coefficient of variation of the corneal endothelia prior to phacoemulsification (P>0. 05) between the three groups. The density and percentage of hexagonal cells of the corneal endothelia decreased significantly after surgery in all three group (P<0.05), while the Coefficient of variation increased in all groups (P< 0.05). The rate of loss of corneal endothelial cells in the diabetic groups was significantly higher than for the control group (P<0.05), the percentage of hexagonal cells in the diabetic groups was significantly lower than for the control group (P<0.05), and the coefficient of variation in the diabetic groups was significantly higher than for the control group (P<0.05) at 1 day, 1 month and 3 months post-operatively. There was no statistical difference between the two diabetic groups in terms of these post-operative measurements.

CONCLUSION

The corneal endothelium of diabetic patients is more prone to damage from phacoemulsification. It is advisable to evaluate the corneal endothelium routinely prior to phacoemulsification, particularly in diabetic persons.