Comparison of corneal higher order aberrations in diabetics versus non-diabetics after cataract surgery

Cataract surgery usually restores vision; however, corneal higher-order aberrations (HOAs) may still affect postoperative visual quality. Diabetes mellitus (DM) can alter corneal structure and may influence corneal HOAs. The aim of this research was to compare the corneal higher order aberrations between diabetic and non-diabetic patients following cataract surgery. This Prospective comparative cohort study was done at ophthalmology department, Mayo Hospital, Lahore. 68 patients (34 in each group) planned for phacoemulsification aged 40–65 years were included. After taking detail history, corneal topography and corneal aberrometry was done by using the Scheimpflug-Placido topographer (Sirius, CSO, Firenze, Italy). For comparison between the groups Mann Whitney U test was applied. p value ≤ 0.05 was considered significant. In this study 68 individuals (34 diabetics and 34 non-diabetics) were enrolled among those 36(52.9%) were male and 32(47.1%) females with mean age of 55.29&SD ±6.1 planned for cataract surgery. Both diabetic and non-diabetic groups showed significant increase in CCT, total corneal HOAs, coma, trefoil, spherical aberrations, and astigmatism II, postoperatively ( p ≤ 0.05). Comparison between groups revealed that the mean ranks of CCT and total RMS corneal HOAs were significantly higher in diabetics compare to non-diabetics ( p < 0.001). RMS coma, trefoil aberrations and astigmatism II were also elevated in diabetics ( p = 0.009, 0.002 and 0.04, respectively). On the other hand, no significant intergroup difference was observed in spherical aberration ( p = 0.10). An increase in CCT and corneal HOAs was seen postoperatively in both groups but elevation was more pronounced in diabetics except spherical aberrations which were comparable in both groups. Additionally, postoperative rise in CCT is significantly associated with RMS total corneal HOAs (moderate correlation) and trefoil (mild correlation), while no such link was found with coma, SA and astigmatism II. These findings suggest a potential difference in corneal response following cataract surgery in diabetic patients, which may have implications for postoperative visual quality assessment.