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Endothelial Cell Loss in Diabetic and Nondiabetic Eyes After Cataract Surgery

He, Xu BA*,†; Diakonis, Vasilios F. MD, PhD*; Alavi, Yasamin BS*; Yesilirmak, Nilufer MD*; Waren, Daniel MSPH*; Donaldson, Kendall MD, MS*

doi: 10.1097/ICO.0000000000001245
Clinical Science

Purpose: To assess and compare the changes in endothelial cell density in diabetic and nondiabetic patients after routine phacoemulsification cataract surgery.

Setting: Bascom Palmer Eye Institute, Miller School of Medicine, Miami, FL, USA.

Design: Retrospective nonrandomized cohort study.

Methods: This retrospective study included diabetic and nondiabetic patients who underwent phacoemulsification by a single surgeon (K.D.) between September 2013 and March 2016. The main outcome measures were cumulative dissipated energy (CDE) and percentage of endothelial cell loss (ECL). Comparative analysis of CDE and percentage of ECL between the 2 patient groups was performed and then repeated based on the degree of diabetic control (hemoglobin A1c).

Results: The study included 66 eyes of 55 diabetic and 67 eyes of 65 nondiabetic patients. Mean CDE was 7.8 ± 7.1 joules, and the 1-month mean percentage of ECL was 15% ± 14% in the diabetic group. Mean CDE was 6.6 ± 3.8 joules, and the 1-month mean percentage of ECL was 11% ± 11% in the nondiabetic group. The CDE was not significantly different between both groups. The percent decrease in ECL was statistically higher in the diabetic group than in the nondiabetic group (P = 0.03). The degree of diabetic control, based on hemoglobin A1c greater or less than 7, did not yield a significant difference in CDE or percentage ECL.

Conclusions: Diabetic patients demonstrated increased ECL when compared with nondiabetic patients after cataract surgery. However, the role of diabetic control in reducing ECL remains unclear.

*Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL; and

Case Western Reserve University School of Medicine, Cleveland, OH.

Reprints: Kendall E. Donaldson, MD, MS, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 8100 SW 10th St, Crossroads 3, 3rd Floor, Plantation, FL 33324 (e-mail: KDonaldson@med.miami.edu).

K. Donaldson is a consultant for Alcon, Allergan, Abbott Medical Optics, Allergan, Omeros, TearLab, SUN, Shire. The remaining authors have no funding or conflicts of interest to disclose.

Received February 22, 2017

Received in revised form April 07, 2017

Accepted April 08, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.