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      Corneal endothelial cell changes in diabetics versus age group matched nondiabetics after manual small incision cataract surgery

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          Abstract

          Purpose:

          To assess and compare the endothelial cell changes after manual small incision cataract surgery (SICS) in diabetic patients versus age group matched non-diabetic patients.

          Methods:

          This comparative prospective observational follow-up study included 54 diabetic patients and 52 control patients without diabetes who underwent manual SICS. Preoperative, one day, one week, one month and three months post-surgery assessments of corneal endothelial cell changes were done using specular microscopy. Data analysis was performed using SPSS software (version 20.0, SPSS, Inc.). Mann–Whitney U test was used to compare the data between the test group and control group.

          Results:

          There was drop in the endothelial density in both the groups postoperatively, with the mean percentage of endothelial loss at three months post- surgery being 27.5% in diabetics and 18.3% in controls. There was also a significant increase in central corneal thickness and coefficient of variance in diabetics as compared to controls at every follow up one day, one week, one month and three months. The percentage of hexagonality was statistically significant at post-operative three months.

          Conclusion:

          The diabetic endothelium was found to be under greater metabolic stress and had less functional reserve after manual SICS than the normal corneal endothelium.

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          Most cited references17

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          Review of corneal endothelial specular microscopy for FDA clinical trials of refractive procedures, surgical devices, and new intraocular drugs and solutions.

          Specular microscopy can provide a noninvasive morphologic analysis of the corneal endothelial cell layer from subjects enrolled in clinical trials. The analysis provides a measure of the endothelial cell physiologic reserve from aging, ocular surgical procedures, pharmaceutical exposure, and general health of the corneal endothelium. The purpose of this review is to discuss normal and stressed endothelial cell morphology, the techniques for determining the morphology parameters, and clinical trial applications.
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            Corneal endothelial cell changes associated with cataract surgery in patients with type 2 diabetes mellitus.

            To investigate the corneal endothelial cell density and morphology in patients with and without diabetes after phacoemulsification with intraocular lens implantation.
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              Changes in the corneal endothelial cell density and morphology in patients with type 2 diabetes mellitus: a population-based study, Sankara Nethralaya Diabetic Retinopathy and Molecular Genetics Study (SN-DREAMS, Report 23).

              To study the corneal endothelial cell density and morphological features in type 2 diabetic patients (cases) and compare it with nondiabetic subjects (controls) in a population-based cross-sectional study.
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                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Wolters Kluwer - Medknow (India )
                0301-4738
                1998-3689
                January 2020
                19 December 2019
                : 68
                : 1
                : 72-76
                Affiliations
                [1]Department of Ophthalmology, A. J. Institute of Medical Sciences and Research Center, Kuntikana, Mangalore, Karnataka, India
                Author notes
                Correspondence to: Dr. Ajay A Kudva, A. J. Institute of Medical Sciences [AJIMS], Mangalore - 575 004, Karnataka, India. E-mail: kudva.ajay@ 123456gmail.com
                Article
                IJO-68-72
                10.4103/ijo.IJO_406_19
                6951183
                31856472
                09d24b7b-015f-44ac-a0ed-3d8359af66b7
                Copyright: © 2019 Indian Journal of Ophthalmology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 27 February 2019
                : 20 July 2019
                : 05 August 2019
                Categories
                Original Article

                Ophthalmology & Optometry
                diabetes mellitus,small incision cataract surgery,endothelial cell loss

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