CORNEAL ENDOTHELIAL CELL DENSITY (ECD) AND CENTRAL CORNEAL THICKNESS (CCT) CHANGES IN TYPE-II DIABETICS AND NORMAL ADULTS AFTER MANUAL SMALL INCISION CATARACT SURGERY (MSICS)- A COMPARATIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 24
Abstract
BACKGROUND Corneal endothelium, the inner most layer of cornea, is a single layer of hexagonal cells, but other cell shapes are also present. This layer is responsible for maintaining the transparency of the cornea. The aim of this study was to find out corneal endothelial cell density (ECD) and central corneal thickness (CCT) changes both preand post-operatively in Type II diabetics and normal adults who underwent Manual Small Incision Cataract Surgery (MSICS) with posterior chamber intraocular lens (PC IOL) implantation. MATERIALS AND METHODS The present study is a prospective, observational, comparative study which was done on patients who underwent manual small incision cataract surgery at Sarojini Devi Eye Hospital from October 2014 to August 2016 using a convenience non-random sampling method. The subjects were divided into two groups as per status of the diabetes: Diabetic group of 50 patients of Type II diabetics and Control group of 50 patients of normal adults. Subject’s age ranged from 60 to 75 years. All patients underwent detailed eye examination including specular microscopy for ECD and CCT preoperatively. ECD and CCT were measured postoperatively on the 1st day, 1st week, 6th week and 12th week. Statistical analysis was done using independent sample student’s t-test with SPSS version 17.0 software. Categorical data analysis was carried out using either chi-square test or Fisher’s exact test as appropriate. RESULTS The mean preoperative ECD was 2621.9 ± 163.3 and 2371.1 ± 155.6 in control and diabetic groups respectively. The postoperative day one, 1st week, 6th week and 12th week’s mean percentage of ECD was 5.5 ± 2.3, 6.4 ± 2.3, 7.7 ± 2.9 and 7.7 ± 2.5 respectively in control patients. It was 10.7 ± 2.7, 12.0 ± 2.4, 13.0 ± 2.4 and 13.6 ± 1.9 respectively in diabetic group. Post-operatively, the % ECD was significantly different between both the groups at each follow-up visit (p < 0.0001) for all. The mean preoperative CCT was 511.5 ± 21.4 and 517.7 ± 16.0 in control and diabetic groups respectively. The percent CCT was not significantly different between groups at each follow-up (p > 0.005) for all. CONCLUSION Compared to non-diabetic patients, diabetic patients showed more loss of corneal endothelial cells in the postoperative period. Central corneal thickness was more in diabetics when compared to non-diabetics, both pre- and post-operatively. Steps should be taken to minimise the insult to corneal endothelium during surgery.
Authors and Affiliations
Battula Yallamanda Babu Rao, Rajender Gupta, Ganganakurthi Uma
Keywords
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- EP ID EP450589
- DOI 10.14260/jemds/2018/652
- Views 66
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