COMPARISON OF CHANGES IN ENDOTHELIAL CELL DENSITY AND MORPHOLOGY AFTER MANUAL SMALL INCISION CATARACT SURGERY IN DIABETICS VS. NON-DIABETICS – A PROSPECTIVE STUDY

Abstract

Purpose: To compare the changes in endothelial cell density (ECD) and morphology after manual small incision cataract surgery (MSICS) in diabetics vs. non-diabetics All consecutive consenting adults Methods: with age related cataract < grade 2 nuclear sclerosis undergoing MSICS were recruited. Specular microscopy was done to document the ECD, coefcient of variation (CoV) and percentage of hexagonality in all eyes before and 1 month after MSICS. The primary outcome measure was the difference in ECD between diabetics and non-diabetics at 1 month compared to baseline. One hundred eyes of 100 Results: patients were recruited in the diabetic (n=50) and non-diabetic (n=50) groups and completed 1 month follow up. There were no differences at baseline, though non-diabetics had marginally higher counts (p=0.07). The mean ECD decreased signicantly in both groups (p<0.001 for both) but this drop was signicantly more in diabetics (566 + 137cells/mm3, 95% CI= 527 to 604) compared to non-diabetics (347 + 94cells/mm3, 95% CI= 320 to 373) (p<0.001). The percentage hexagonality decreased slightly after MSICS in both, although by the same magnitude (-6.4 + 3.7 in diabetics vs. -5.2 + 3.9%, p=0.09) where as the CoV changed more (-5.8 + 5.5 in non-diabetics vs. 2.9 + 2.6, p<0.001) in the diabetic group. Eyes Conclusions: with softer cataracts in diabetics undergoing MSICS experience much greater endothelial cell loss at 1 month, though changes in the morphology such as percentage hexagonality and CoV are not as marked.