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PREDISPOSING FACTORS FOR ENDOTHELIAL CELL INJURY IN DIABETIC PATIENTS FOLLOWING PHACOEMULSIFICATION

Dr. Fereshteh Kargar Bafrani, Dr. Luxhman Gunaseelan, Dr. Harman Fervaha, Dr. Mohamed Jamal Halane, Faranak Kargar Bafrani, Dr. Abdul Subhan Talpur

Aim:- To determine the risk factors contributing to the Endothelial Cell Loss (ECL) in diabetics following Phacoemulsification as compared to age and sex matched Non-diabetics. Results:- It was found that Diabetics in the age group 60-69 have 4.1 times more risk of ECL than control group (OR:4.1, C.I: 1.218-2.976, p=0.03). The other major risk factors such as Effective Phaco Time (EPT) (OR: 3.1, C.I: 1.721-9.332, p=0.04), Ultrasound time (UST) (OR: 2.8, C.I: 1.416-5.727, p=0.02) and Inflammation score (OR: 4.3, C.I: 2.529-14.762, p=0.01) were significantly associated with higher risk of ECL in diabetics more than Non-diabetics. We found reduced Endothelial Cell Density (ECD), Increased Central Corneal Thickness (CCT) with statistical significance (p= 0.04, 0.03 respectively). Coefficient of variation (CV) and Hexagonality did not show any statistically significance in ECL during follow-up of 3 months post-operatively. Materials and Methods: - This is a case-control study employed at Parsian Eye Clinic, Islamic Azad University, Iran with 60 patients in each Diabetic and Control group. The pre-operative baseline characteristics were obtained, Intra-operative Ultrasound time (UST), Effective Phaco Time (EPT) and post-operative Endothelial Cell Density (ECD), Central corneal thickness (CCT), Coefficient of variation (CV) and Hexagonality at 1-week, 1-month and 3-months following phacoemulsification were measured using Keelar-Konan specular microscope (Model- CSP 580). Conclusion: - Our study suggests that diabetics has profound ECL, increased CCT and reduced Hexagonality following phacoemulsification. It was found that EPT, UST and Inflammation score are associated with higher risk of ECL and more so in Diabetics as compared to control group. Future studies with larger sample size and longer follow-up with alternative surgical techniques are warranted taking in account other possible factors determining the Endothelial injury. Keywords: Phacoemulsification, Cataract, Endothelial Cell Loss, Diabetes.

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