Does Well-Controlled Type 2 Diabetes Mellitus Affect Corneal Endothelium? A Comparative Study.

Area of Science:

• Ophthalmology
• Endocrinology
• Cell Biology

Background:

• Type 2 diabetes mellitus is a systemic disease with potential ocular manifestations.
• The corneal endothelium plays a crucial role in maintaining corneal clarity and function.
• Subtle changes in corneal endothelium parameters may occur even in well-controlled diabetes.

Purpose of the Study:

• To compare corneal endothelium parameters between patients with well-controlled type 2 diabetes and a non-diabetic control group.
• To investigate the impact of diabetes on endothelial cell density (ECD), hexagonal cell percentage (%HEX), cell size variation (CV), and central corneal thickness (CCT).

Main Methods:

• A comparative study involving 80 patients with well-controlled type 2 diabetes and 80 age/sex-matched controls.
• Corneal endothelium parameters (ECD, %HEX, CV, CCT) were measured using non-contact specular microscopy.
• Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were also assessed.

Main Results:

• Patients with type 2 diabetes had significantly lower endothelial cell density (ECD) (2480.76 cells/mm² vs. 2629.64 cells/mm², p=0.002).
• Best-corrected visual acuity (BCVA) was significantly lower in the diabetic group (0.44 vs. 0.50, p=0.049).
• No significant differences were observed in %HEX, CV, CCT, or IOP between the groups.

Conclusions:

• Well-controlled type 2 diabetes is associated with reduced corneal endothelial cell density, irrespective of advanced diabetic complications.
• These findings suggest potential clinical implications for preoperative assessment and long-term eye health management in diabetic patients.
• Other corneal endothelial morphological parameters remained comparable, indicating specific sensitivity of ECD to diabetes.