| Objectives To observe the dynamic changes of corneal endothelium in patients with type 2 diabetes mellitus after phacoemulsification.Methods This study was performed in Age-related cataract patients who underwent cataract surgery(phacoemulsification and intraocular lens implantation)at the General Hospital of Ningxia Medical University ophthalmology from Jul 1,2017 to Dec 1,2017.There are 95 patients(160 eyes)who have been followed up.The patients were assigned into two groups.46(80 eyes)patients with type 2 diabetes were selected as the diabetes group,and 49(80 eyes)patients were in the control group.Additionally we divided the two groups: II group,III group,IV group,V group,according to the degree of hardness of the lens nucleus.The corneal endothelium in the central area were measured before surgery and followed up at day 7,day 30 and day 90 postoperatively with a noncontact Specular Microscope SP-3000.To compare the two groups in corneal endothelial cell density(ECD),the percentage of hexagonal cells,and coefficient of variation(CV),the central cornea thickness(CCT).Results 1.There was no significant difference in ECD between the two groups in preoperation(P > 0.05).The ECD of the two groups in postoperative was lower than the preoperative,and the diabetic group was significantly lower than the control(P < 0.001).There was no difference in ECD between the two groups at different nuclear hardness levels(P > 0.05).There was no significant difference in ECD between the diabetic group and the control group at each time after operation at grade II nuclear hardness(P>0.05);From the grade III to V nuclear hardness,the ECD of the diabetic group was higher than the control group at each time after operation(P < 0.05).2.There was no significant difference in the percentage of hexagonal cells between the two groups before operation(P > 0.05).The percentage of hexagonal cells in the diabetic group was lower than the control group at every time after operation(P < 0.001).The percentage of hexagonal cells in the diabetic patients from day 1 to day 90 was lower than pre-operation.At different nuclear hardness levels,there was no difference in the percentage of hexagonal cells between the two groups before operation(P > 0.05).With the increase of nuclear hardness,the difference in the percentage of hexagonal cells between the two groups was significant at every time after operation(P < 0.05).3.There was no significant difference in CV between the two groups before operation(P > 0.05).The CV of diabetic group was higher than the control group from the 1st to 7th day after operation,and the CV of the two groups decreased on the 30 th day,the CV of 90 th day after operation was no significant difference between the two groups(P > 0.05).4.The CCT of the two groups was no difference before operation(P > 0.05).the CCT of diabetic group was higher than the control of from 1th day to 7th day after operation(P < 0.05),the recovery time of the diabetic group was longer than that of the control group(P < 0.05).There was no significant difference in CCT between the two groups of 30 and 90 days after operation(P > 0.05).Conclusions The corneal endothelial morphology and central corneal thickness of the diabetic patients were changed after phacoemulsification and intraocular lens implantation.The morphological parameters of the endothelial cells and the central corneal thickness in the diabetes group were similar to the normal control group.The percentage of ECD and hexagonal cells in the diabetic group decreased significantly after the operation,and did not recover completely with the progress of time.Although the preoperative blood glucose in the diabetic group was well controlled and the corneal endothelial function was normal,the corneal endothelial damage in diabetic patients was still more severe than that of normal patients,it is significant that the ability of corneal endothelial cells to resist surgical injury in diabetic patients is reduced.Therefore,we suggest that diabetic patients need to undergo cataract surgery as early as possible,the ophthalmologist should carefully evaluate the condition before operation,and also pay attention to the protection of the corneal endothelial cells during operation,reduce the risk of operation and obtain better visual quality. |
PDF Full Text Request