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Risk factors for endothelial cell damage in diabetics after phacoemulsification
Niruban Ganesan1, Renuka Srinivasan2, K Ramesh Babu2
1Cornea and Refractive Services, Aravind Eye Hospital, Puducherry, India.
Oman Journal of Ophthalmology
|June 15, 2019
Summary
Postoperative inflammation increases endothelial cell loss risk in diabetic patients after phacoemulsification. Intraoperative factors like mydriasis and effective phaco time were not significant risk factors for endothelial cell damage.
Area of Science:
- Ophthalmology
- Diabetic Retinopathy
- Corneal Science
Background:
- Phacoemulsification is a common cataract surgery.
- Diabetic patients may have increased risk of complications.
- Assessing corneal endothelium health post-surgery is crucial.
Purpose of the Study:
- Compare endothelial cell damage after phacoemulsification in diabetic versus non-diabetic patients.
- Identify factors associated with endothelial cell damage in diabetics.
Main Methods:
- Case-control study with 80 diabetic and 80 non-diabetic eyes.
- Measured intraoperative mydriasis, effective phaco time (EPT), and postoperative inflammation.
- Assessed endothelial cell density (ECD), coefficient of variation (CV), hexagonality, and central corneal thickness (CCT) preoperatively and postoperatively.
Main Results:
- In controls, older age (60-69) and longer EPT (≥0.50 min) increased endothelial cell loss (ECL) risk.
- In diabetics, postoperative inflammation (1+ score) significantly increased ECL risk (5.7 times).
- Diabetics showed increased CV and CCT, and decreased hexagonality post-surgery compared to controls.
Conclusions:
- Postoperative inflammation is a significant risk factor for endothelial cell loss in diabetic patients undergoing phacoemulsification.
- Intraoperative mydriasis and effective phaco time are not primary risk factors for ECL in this population.
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