Corneal Changes After Small-Incision Cataract Surgery in Patients WithDiabetes Mellitus

Morikubo, Soichi; Takamura, Yoshihiro; Kubo, Eri; Tsuzuki, Shosai; Akagi, Yoshio

doi:10.1001/archopht.122.7.966

Cited by 100 publications

(106 citation statements)

References 25 publications

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“…[1][2][3][4][5][6][7][8][9][10]13,14 Majority of these reports showed that diabetic corneas were thicker when compared to non-diabetic healthy eyes. [5][6][7][14][15][16] Investigators demonstrated that endothelial pump dysfunction due to hyperglycaemia has been shown as the main mechanism of increased CCT.…”

Section: Discussionmentioning

confidence: 99%

“…Investigators showed that high glucose levels lead to increased activity of aldose reductase. [1][2][3][4][5][6][7][8][9] As a result of increased activation of sorbitol-aldose reductase pathway; sorbitol is over produced and it is an osmotic agent which causes swelling of endothelial cells. Other unfavourable effect of DM on endothelial cells is reducing activity of Na + -K + ATPase pump.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Moreover, diabetes make the cornea more fragile and risky for ocular surgery. 9,10 The aim of this study is to compare the central corneal thickness (CCT) and corneal endothelial parameters in patients with uncontrolled type II DM and healthy subjects using noncontact specular microscope. To best of our knowledge, there are only a few reports about corneal endothelial parameters in patients with uncontrolled type II DM in literature.…”

mentioning

confidence: 99%

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Corneal Endothelial and Central Corneal Thickness Changes in Patients with Uncontrolled Type II Diabetes Mellitus

Mete¹,

Kimyon²,

Çeri³

et al. 2018

Turkiye Klinikleri J Ophthalmol

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ype II diabetes mellitus (DM) has become worldwide epidemic. By 2025, it is estimated that global prevalence will be approximately 380 million for type 2 DM.1,2 It is a chronic metabolic disease characterized by hyperglycaemia and affects the corneal epithelium, epithelial basement membrane complexes, stroma and endothelial cells. [3][4][5] Investigators showed that diabetes causes corneal morphology and endothelium abnormalities and it may cause physiological instability in In this prospective comparative-observational study, we investigated right eyes of 40 patients (40 eyes) with uncontrolled type 2 DM as study group and right eyes of 43 healthy control subjects (43 eyes). Central corneal thickness (CCT) and corneal endothelial parameters including endothelial cell density (ECD), coefficient of variation of cell area (CV) and percentage of hexagonal cells were examined using non-contact specular microscopy. All obtained data were compared statistically between groups. R Re es su ul lt ts s: : The study group had significantly increased mean CCT and reduced mean ECD values when compared with control group. The diabetic corneas also had higher percentage of CV in cell size and lower percentage of hexagonal cells than the control group, but the difference was not statistically significant. C Co on nc cl lu us si io on n: : The CCT was increased and ECD was reduced significantly in uncontrolled type II DM patients. This study also demonstrated that study group had higher percentage of CV in cell size and had lower percentage of hexagonal cells. K Ke ey yw wo or rd ds s: : Corneal endothelium; central corneal thickness; uncontrolled type II diabetes; specular microscopy Ö ÖZ ZE ET T A Am ma aç ç: : Kontrolsüz tip 2 diabetes mellitus (DM) hastalarında ve sağlıklı gönüllülerde santral kornea kalınlığı (SKK) ve kornea endotel parametrelerinin karşılaştırılması. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu prospektif karşılaştırmalı-gözlemsel çalışmada kontrolsüz tip 2 DM'si olan 40 hastanın sağ gözü (40 göz) ve 43 sağlıklı gönüllünün sağ gözü (43 göz) incelendi. Santral kornea kalınlığı (SKK) ve endotel hücre yoğunluğu (EHY), hücre alanı varyasyon katsayısı ve hekzagonalite yüzdesini içeren kornea endotel parametreleri temassız speküler mikroskop ile değerlendirildi. Elde edilen veriler iki grup arasında istatistiksel olarak karşılaştırıldı. B Bu ul lg gu ul la ar r: : Kontrol grubu ile kıyaslandığında çalışma grubunun ortalama SKK'ı anlamlı olarak artmış, ortalama EHY'si anlamlı olarak azalmıştı. Kontrolsüz diyabetli grupta hücre alanı varyasyon katsayısı daha yüksekti ve hekzagonalite yüzdesi daha düşüktü fakat istatistiksel olarak anlamlı fark tespit edilmedi. S So on nu uç ç: : Kontrolsüz tip 2 DM'li hastalarda SKK anlamlı olarak artmış ve EHY anlamlı olarak azalmıştır. Çalışmamızda DM'li grupta daha yüksek oranda hücre alanı varyasyon katsayısı ve daha düşük oranda hekzagonal hücre izlenmiştir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Kornea endoteli; santral kornea kalınlığı; kontrols...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Corneal Endothelial and Central Corneal Thickness Changes in Patients with Uncontrolled Type II Diabetes Mellitus

Mete¹,

Kimyon²,

Çeri³

et al. 2018

Turkiye Klinikleri J Ophthalmol

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“…18,19 Nitekim bizim olgularımızdan da DM'si olan 2 olguda %32 oranında EHS'de azalma görülürken, diğer 5 olgudaki ortalama azalmanın %19 düzeyinde olduğunu saptadık.…”

Section: Discussionunclassified

Kombine Fakoemülsifikasyon-Arka Kamara Göz içi Lens Yerleştirilmesi ve Transpupiller Silikon Yağının Çıkarılmasına Bağlı Kornea Endotel Hücre Değişimi

Hanifi¹,

Esgin²

2014

tjo

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Amaç: Kombine fakoemülsifikasyon-arka kamara göz içi lensi (AK-GİL) yerleştirilmesi ve transpupiller silikon yağı çıkarılmasının kornea endotel hücre tabakası üzerine etkisini incelemek. Objectives: The aim of this study was to evaluate the effects of combined phacoemulsification-posterior chamber intraocular lens (PC-IOL) implantation and removal of transpupillary silicone oil on the corneal endothelial cell layer. Ma te ri als and Met hods:In this study, we included seven eyes of 7 patients who had intravitreal hemorrhage resulting from retinal detachment or tractional retinal detachment due to proliferative diabetic retinopathy and who underwent pars plana vitrectomy and silicone oil injection. Complicated cataract developed, and phacoemulsification-PC-IOL implantation combined with transpupillary silicon oil removal were performed. Preoperative and postoperative corneal endothelial cell count values were taken by Topcon SP-2000P automatic non-contact specular microscopy and were assessed by IMAGEnet 2000 Endothelial Cell Analysis. The results were compared with the findings in the literature. Re sults: The mean endothelial cell density (ECD) was 2461 cell/mm2 preoperatively. The silicone oil removal was performed after an average of 10±3.5 months (range 5-14 months), and then endothelial cells were counted after a mean of 17±21.2 months (range 1-49 months) of the combined surgery. The mean ECD was determined as 1906 cell/mm 2 postoperatively. While mean endothelial cell loss was found to be 32% in two patients with diabetes mellitus, five non-diabetic patients had 19% cell loss. Corneal decompensation was not observed in any patient during the follow-up period. Conclusion: After combined phacoemulsification-PC-IOL implantation and transpupillary silicone oil removal, significant reduction in endothelial cells was observed. We detected that this reduction was greater in diabetics. (Turk J Ophthalmol 2014; 44: 424-7)

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“…[71][72][73] This mechanically induced cell loss is greater in the diabetic cornea. 74,75 As such, greater effort and care should be utilized to minimize surgical trauma, by avoiding phaco power near the cornea and using viscoelastics generously to cushion the endothelium. Attention to wound construction and manipulation is also important in an attempt to minimize epithelial injury as well.…”

Section: Ocular Surgerymentioning

confidence: 99%

The Cornea in Diabetes Mellitus

Hasan

2010

Diabetic Retinopathy

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Corneal Changes After Small-Incision Cataract Surgery in Patients WithDiabetes Mellitus

Cited by 100 publications

References 25 publications

Corneal Endothelial and Central Corneal Thickness Changes in Patients with Uncontrolled Type II Diabetes Mellitus

Corneal Endothelial and Central Corneal Thickness Changes in Patients with Uncontrolled Type II Diabetes Mellitus

Kombine Fakoemülsifikasyon-Arka Kamara Göz içi Lens Yerleştirilmesi ve Transpupiller Silikon Yağının Çıkarılmasına Bağlı Kornea Endotel Hücre Değişimi

The Cornea in Diabetes Mellitus

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