Corneal Endothelial Changes in Patients with Diabetes after Manual Small Incision Cataract Surgery (MSICS)

Abstract

Background: Diabetes mellitus may make patients more vulnerable to endothelial damage during cataract surgery because it is linked to structural and functional alterations in the corneal endothelium. Although manual small incision cataract surgery (MSICS) is still often done in developing nations, little is known about how the endothelium changes in diabetes individuals after MSICS.

Objective: To assess ocular endothelium alterations over a one-year follow-up in diabetic patients receiving MSICS.

Methods: There were 97 diabetic individuals receiving MSICS in this prospective observational trial. Preoperatively, as well as one week, one month, three months, and twelve months after surgery, specular microscopy was carried out. Endothelial cell density (ECD), coefficient of variation (CV), and the proportion of hexagonal cells were among the parameters that were examined. The paired t-test was used for statistical analysis, and a p-value of less than 0.05 was deemed significant.

Results: After surgery, the mean endothelial cell density dropped from 2548 ± 210 cells/mm² to 2215 ± 230 cells/mm² at 12 months (p <0.001). The average loss of endothelial cells was 13.1%. There were notable declines in hexagonality and increases in CV (p <0.01). The early postoperative phase was when the majority of endothelium loss happened.

Conclusion: Over the course of a year, diabetic patients receiving MSICS exhibit a notable loss of endothelial cells. To maintain endothelial health, careful surgical approach and after surveillance are crucial.

Keywords: Endothelial cell density, postoperative, diabetic patients, coefficient of variation, manual small incision cataract surgery (MSICS)