Evaluation of corneal endothelium following cataract surgery in diabetic patients

PURPOSE: The aim of this study was to evaluate the influence of cataract surgery on the condition of corneal endothelium, in diabetic patients. MATERIAL AND METHODS: We examined 103 patients (103 eyes) after cataract surgery (64 women and 39 men), at the age between 49 and 89. In our study we didn't involve any patients with intra or post-surgery complications. Using Specular Microscope SP-1000 corneal endothelium was examined before cataract surgery and in the long-term follow-up: 7, 30 and 90 days after surgery. The patients were divided into two groups: suffering from diabetes (54) and matched control group--non-diabetic patients with cataract (49). The same patients were also divided depending on the type of surgical technique: phacoemulsification (42) or extracapsular cataract extraction (61). RESULTS: The mean percent loss of corneal endothelium cells, due to surgery in diabetic patients was: 11.31% after 7 days, 13.99% after 30 and 15.38% after 90 days. In the control group: 5.45% after 7 days, 8.66% after 30 and 11.33% after 90 days. The mean percent loss of corneal endothelium cells after phacoemulsification was: 10.10% after 7 days, 13.21% after 30 and 15.87% after 90 days; after extra-capsular cataract extraction: 6.84% after 7 days, 9.71% after 30 and 11.48% after 90 days. Differences between mean value of corneal endothelial cells in diabetic patients compared with control group, were statistically essential 7 and 30 days after cataract surgery, and near such assessment 90 days after surgery. There were no statistically essential differences between endothelial cells density in both operated groups, in relation to type of operation (phacoemulsification and extra-capsular cataract extraction). CONCLUSIONS: Above results are the evidence, that cataract surgery is a big trauma for cornea, especially for its endothelium. The operation is mainly dangerous for patients suffering from diabetes. The surgeon should be aware of the above threat during cataract surgery in diabetic patients, and therefore should express high level of caution, irrespective of the technique of operation.