This study showed that CED in Pakistani eyes was less than that reported in Chinese eyes, higher than Portuguese, Iranian and Indian eyes and comparable to the values in Turkish, Nigerian and Thai eyes.

Objective:To compare corneal morphological parameters between diabetics and age matched non-diabetic control subjects and to evaluate the correlation of these parameters in relation to duration of diabetes mellitus (DM), glycemic status and severity of diabetic retinopathy.(DR).Methods:This cross sectional comparative study was conducted at the Department of Ophthalmology, PNS Shifa Karachi from February 2016 to January 2017. Patients with ages between 10 to 80 years of either gender who were diagnosed to have DM were recruited in the study. Control group comprised of age matched healthy volunteers who did not have DM. Corneal morphological parameters (CED, Average cell size, CV of cell size and hexagonality) was evaluated in each subject with non-contact specular microscope and findings were endorsed on a pre devised proforma.Results:Data of 298 eyes (149 diabetic patients and 149 healthy controls) was evaluated. Mean corneal endothelial cell density (CED) of diabetic population was 2494.47 ± 394.10 cells/mm2, while mean CED of control group was 2574.46 ± 279.97 cells/mm2 [p = 0.04]. Between group differences in mean average cell size, CV of cell size and hexagonality was statistically not significant. Analysis of corneal endothelial parameters among subgroups of patients with no DR, with NPDR and PDR did not show statistically significant difference. Moreover, patients with diabetes of more than 10 years duration had significantly lower CED (p <0.01) and larger average cell size (p= 0.03). Duration of DM was significantly correlated with type of DR, HbA1c level, CED, polymegethism and hexagonality.Conclusion:Mean corneal endothelial cell density (CED) was found to be significantly lower in diabetic population as compared to healthy controls.

Objective:To determine the efficacy of topical Nepafenac (0.1%), administered post-operatively in prevention of Macular Edema (ME), after cataract surgery in patients with Non-Proliferative Diabetic Retinopathy (NPDR).Methods:This randomized control trial was conducted at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from Sep 2015 to Sep 2016. Sixty eyes of 60 patients with NPDR underwent phacoemulsification with intraocular lens implantation. Group 1 received 0.1% Nepafenac, 8-hourly, in operated eye after cataract surgery for three months, along with routine post-operative medications. Group-2 received only routine post-operative medications. ME was defined as increase in Central Macular Thickness (CMT) of >10% from pre-operative baseline, measured using spectral domain optical coherence tomography.Results:Mean age of study population was 60.97±4.91 years. Out of 60 patients, 34 (56.7%) were males and 24 (43.3%) were females. Mean pre-operative CMT, 3 months post-operative CMT, mean change in CMT and mean frequency change in CMT of Group-1 was 226.5±10.86µm, 228.83±14.56 µm, 2.33±10.45 µm and 1.05% respectively. Mean pre-operative CMT, three months post-operative CMT, mean change in CMT and mean frequency change in CMT in Group-2 was 223.93±11.69µm, 236.17±16.16 µm, 12.23±12.40µm and 5.51% respectively. ME was observed in one patient (3.3%) in Group-1, and seven patients (23.3%) in Group 2. The difference of mean change in CMT and frequency change in CMT between groups was statistically significant (p<0.05).Conclusion:0.1% topical Nepafenac is effective in prevention of macular edema after cataract surgery in patients with non-proliferative diabetic retinopathy (NPDR).

Objective: To evaluate mean decrease in Corneal Endothelial cell Density (CED) after phacoemulsification in patients with different Anterior Chamber Depths (ACDs) and Axial Lengths (ALs). Methods: This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. One hundred eyes of 90 patients, scheduled to undergo phacoemulsification surgery, were included. AL and ACD of each patient were calculated preoperatively using IOL Master. Cataracts were classified according toLens Opacities Classification System III (LOCS III) giving nuclear opalescence (NO) grades on slit lamp examination and only patients with grades NO2 and NO3 were included.Eyes were divided into two groups according to ACD and AL: Group-I: ACD 2.0mm – 3 mm and AL 22mm – 23.5mm; Group-II: ACD 3.1 mm -4.0 mm and AL 23.6mm – 25mm. CED measurements were done preoperatively and 2 month postoperatively using specular microscopy. The difference in CED change (Endothelial Cell Loss) between the two groups after surgery was analyzed using SPSS, v 22; IBM Corporation, Armonk, NY. Results: Differences in gender, laterality, age and preoperative CED between two groups were not significant. Difference in postoperative CED was also not significant, however difference in mean change and mean frequency change in CED between two groups was found to be statistically significant. Conclusion: ACD and AL affect the CED during phacoemulsification and Intraocular Lens(IOL) implantation and can be considered as risk factors of peroperative endothelial cell loss. How to cite this:Khalid M, Ameen SS, Ayub N, Mehboob MA. Effects of anterior chamber depth and axial length on corneal endothelial cell density after phacoemulsification. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.92 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To compare the difference in peripapillary Retinal Nerve Fibre Layer (RNFL) thickness between normal population and Type-II diabetic patients without diabetic retinopathy using Spectral Domain Optical Coherence Tomography (SD OCT). Methods: This cross sectional study was carried out at PNS Shifa Naval Hospital, from May 2017 to November 2017. Out of 200 eyes, 100 eyes were of normal individuals and 100 eyes were of Type-II diabetic patients without diabetic retinopathy. Both groups were age and gender matched. Average RNFL thickness, along with RNFL of each quadrant of individuals was noted using SD OCT, and compared between two groups. Results: Mean age of study population was 44.63 ± 4.30 years. Mean axial length was 23.46 ± 0.59 mm. Mean peripapillary RNFL thickness was 126.98 ± 10.07 µm in Group-A (normal individuals), and 120.77 ± 5.41 µm in Group-B (Type-II diabetics). Difference in mean RNFL thickness, as well as RNFL thicknesses of each quadrant was statistically significant between both groups (p-value < 0.001). Conclusion: Diabetic patients have thin RNFL as compared to normal individuals, and must be taken in account while making diagnosis of any disease based on thinning of RNFL. How to cite this:Mehboob MA, Amin ZA, Qamar Ul Islam. Comparison of retinal nerve fiber layer thickness between normal population and patients with diabetes mellitus using optical coherence tomography. Pak J Med Sci. 2019;35(1):---------.  doi: https://doi.org/10.12669/pjms.35.1.65 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.