OCT-Based Quantitative Comparison of Full-Thickness Healing of Corneal Incisions in Cataract Surgery Between Diabetic and Nondiabetic Patients

PURPOSE: To quantify full-thickness healing of clear-corneal incisions after cataract surgery in patients with and without diabetes, thereby providing evidence-based foundation for perioperative care. METHODS: In this retrospective cohort, 141 eyes (51 diabetic, 90 nondiabetic) that underwent phacoemulsification were followed. Corneal epithelial healing was assessed via fluorescein staining at 1 week. Anterior segment optical coherence tomography was used to measure the volume of the hemi-cornea containing the surgical incision and its rate of change (RCVHCSI) postoperatively at 1 week and 1 month. Structure defects-internal gape, endothelial misalignment, and Descemet membrane detachment-were recorded. RESULTS: At 1 week, compared with the nondiabetic group, diabetic eyes showed slower epithelial healing (80.39% vs. 92.22%, P = 0.038) and greater corneal edema (RCVHCSI 5.62% vs. 3.68%, P = 0.017). They also exhibited more internal gape (39.22% vs. 16.67%, P = 0.003), endothelial misalignment (15.69% vs. 2.22%, P = 0.008), and Descemet membrane detachment (27.45% vs. 12.22%, P = 0.023). In diabetic eyes, higher preoperative intraocular pressure (IOP) increased the odds of gape (odds ratio [OR] = 1.26, P = 0.010), whereas older age increased the risks of misalignment (OR = 1.14, P = 0.038) and detachment (OR = 1.26, P = 0.002). Age correlated positively with 1-week RCVHCSI, and male patients showed higher 1-month RCVHCSI. CONCLUSIONS: Diabetes delays corneal incision healing and amplifies incision-related edema and structural defects, elderly male diabetic patients with higher preoperative intraocular pressure are more prone to delayed corneal incision.