Comparison of endothelial cell loss using specular microscopy in diabetic verses non-diabetic patients undergoing phacoemulsification surgery at an eye hospital in central India

Diabetes mellitus causes several ophthalmic complications including retinopathy, cataract, and damage to the anterior chamber of the eye including various layers of the cornea. To compare endothelial cell loss after phacoemulsification surgery for cataracts among diabetics and non-diabetic patients. A single-centre, hospital-based, prospective, comparative, 1:1 observational study enrolling participants a total of 200 participants were enrolled (100 diabetic and non-diabetic) and were followed up from the preoperative period to 3 months after surgery. The data pertaining to endothelial cell density, coefficient of variance, endothelial cell hexagonality and central corneal thickness were recorded using specular microscopy before, 1-, 7-, 30-, and 90 days after cataract surgery. There was a significant difference (p<0.05) in the endothelial cell density, coefficient of variance, endothelial cell hexagonality, and central corneal thickness among the diabetic and non-diabetic patients at each follow-up visit after surgery. The ECD was comparatively lowest among the participants with >10 years of diabetes and highest among patients with < 5 years of diabetes. The percentage change in ECD on days 1-, 7-, 30-, and 90 days of cataract surgery among the diabetic patients was 8.8%, 11.7%, 12.9% and 18.7%, respectively. The mean ECH among the patients with < 5 years, 5-10 years, and > 10 years of diabetes was 65.7%, 62.5% and 57.5%, respectively. In comparison to non-diabetic patients, there was a considerable loss of endothelial cell function among diabetic individuals following cataract surgery. Furthermore, a slower and poorer healing response was seen in patients with diabetes.