[The corneal endothelium of diabetic patients. A study using specular microscopy]

As the endothelial cells of the human cornea cannot perform mitosis, any metabolic alteration that destroys the cells should result into a decrease in cell density. This study was designed to demonstrate this phenomenon in diabetics as we know that diabetes alters endothelial cells, capillaries at least. On the assumption that capillary endothelium has the same mesodermal origin and almost the same metabolic function as the corneal endothelium, we tried to verify whether the corneal endothelium from diabetic subjects differs from non diabetic controls. As corneal endothelium can be studied in vivo by specular microscopy, it was interesting to verify whether this method could provide evidence of the conditions of the endothelial cells in the diabetic subject. Our study in specular microscopy involved 101 cases. We found slightly inferior values of the corneal endothelial cells density in diabetic subjects compared to the control subjects but no correlation between the values of endothelial cell density and the various parameters in diabetic patients: age, duration of diabetes, corneal thickness. This is correlated to other studies in which the morphology of endothelial cells differed between diabetic and non-diabetic subjects. We concluded that diabetes alters but does not significantly destroy the corneal endothelial cell. This result must be taken into account in corneal surgery as the diabetic cornea is a high risk cornea.