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Evaluation of the corneal thickness and endothelial changes following uncomplicated phacoemulsification in diabetic and non-diabetic patients with pseudo-exfoliation syndrome by specular microscopy

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Abstract

Purpose

To evaluate corneal endothelial cell changes following uncomplicated phacoemulsification in diabetic patients with PEX, compared with diabetic patients and non-diabetic patients with PEX.

Methods

This prospective, comparative, non-randomized cohort study included 61 eyes of 61 patients who were diagnosed as having senile cataract. Patients were divided into three groups: Group (1) included 19 eyes of patients with DM and PEX, group (2) included 22 eyes of diabetic patients, and group (3) included 20 eyes of patients with PEX. All included patients had uncomplicated phacoemulsification with IOL implantation. Patients were examined by non-contact specular microscopy (NIDEK, CEM-530, Japan), preoperatively and postoperatively at regular follow-up periods (one, three, and six months postoperatively) with analysis of the endothelial cell density, percentage of hexagonal cells, CV, and CCT.

Results

By the end of follow-up period, there was a statistically significant reduction in ECD and HEX with a significant increase in CV and CCT in group one (DM-PEX). In group two (DM), a statistically significant decrease in ECD and HEX with a significant increase in CCT was reported, while in group three (PEX), the only significant difference was found in the form of ECD reduction.

Conclusion

Patients with DM and PEX had significant changes regarding ECD, CV, HEX, and CCT which were more pronounced than in patients with DM only or PEX only. More attention should be paid while operating on diabetic patients with PEX to save corneal endothelium and decrease postoperative complications.

Study registration number

The study was retrospectively registered (16 July 2021) on ClinicalTrials.gov (NCT04965168).

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Data availability

All data generated or analyzed during this study are included in this article.

Abbreviations

PEX:

Pseudo-exfoliation syndrome

DM:

Diabetes mellitus

ECD:

Endothelial cell density

CCT:

Central corneal thickness

LOCS III:

Lens opacity classification system III

HbA1c:

Hemoglobin A1c

IOL:

Intra-ocular lens

SPSS:

Statistical package for social sciences

CV:

Coefficient of variation

HEX:

Percentage of hexagonality

HC%:

Hexagonal cell percent

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Funding

No financial support was received for this study.

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Authors and Affiliations

  1. Ophthalmology Department, Faculty of Medicine, Minia University Hospital, Minia, Egypt

    Mohamed Salah El-Din Mahmoud, Ismail Ahmed Nagib Omar & Heba Radi AttaAllah

Authors
  1. Mohamed Salah El-Din Mahmoud
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  2. Ismail Ahmed Nagib Omar
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  3. Heba Radi AttaAllah
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Contributions

All authors (MSM, IAN, and HRA) participated in this work through all its stages. All authors read and approved the final manuscript. Ophthalmology Department, Minia University, El‑Minia, Egypt.

Corresponding author

Correspondence to Heba Radi AttaAllah.

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The authors declare that they have no competing interests.

Ethics approval and consent to participate

The study was approved by the local research ethics committee of the Faculty of Medicine, Minia University, Research Ethics Committee “FMREC” (Approval No: 691:11/2020), and was adherent to the tents of the Declaration of Helsinki. Written informed consent to participate was obtained from all of the participants in current study.

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Mahmoud, M.SD., Omar, I.A.N. & AttaAllah, H.R. Evaluation of the corneal thickness and endothelial changes following uncomplicated phacoemulsification in diabetic and non-diabetic patients with pseudo-exfoliation syndrome by specular microscopy. Int Ophthalmol 43, 4773–4780 (2023). https://doi.org/10.1007/s10792-023-02877-x

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  • DOI: https://doi.org/10.1007/s10792-023-02877-x

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