Endothelial changes in patients with and without diabetes after manual small-incision cataract surgery.

L A Oseguera Chávez, L E Salas Medina, C Palacio Pastrana, W Cedillo Suárez
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Abstract

Background and objective: In Mexico there is a high prevalence of diabetes, which is one of the most frequent etiologies of cataract. The impact of diabetes on postoperative corneal decompensation associated with MSICS has not been studied in our country. The objective of the study was to determine the difference in corneal endothelial changes between diabetic and non-diabetic patients by preoperative specular microscopy and at one month and 3 months after MSICS.

Patients and methods: Prospective, longitudinal, paired, non-randomized study with two groups; Group 1: diabetic patients and Group 2: non-diabetic patients. All patients had a complete ophthalmologic evaluation and preoperative and postoperative specular microscopy at one month and 3 months.

Results: 119 eyes were included. The percentage of CD loss at 1 month was 11.1% in diabetic patients and 6.3% in non-diabetic patients. At 3 months the percentage of loss was 9.9% in diabetic patients and 5.4% in non-diabetic patients. The CV was higher in patients with diabetes and was significant at 1 month; however, at 3 months the values ​​were comparable. The percentage of HEX decreased significantly in the first month in patients with diabetes.

Conclusions: There was a significant difference with greater CD loss, greater CV and less HEX in patients with diabetes vs. without diabetes at 1 month after the M-SICS procedure, however, it was not statistically significant at 3 months. This suggests greater endothelial stress, longer recovery time and remodeling of the corneal endothelium in patients with diabetes.

糖尿病患者和非糖尿病患者手工小切口白内障术后内皮细胞的变化。
背景和目的:在墨西哥,糖尿病的患病率很高,这是白内障最常见的病因之一。糖尿病对msic术后角膜失代偿的影响在国内尚未见相关研究。本研究的目的是通过术前、术后1个月和3个月的镜面显微镜观察糖尿病患者和非糖尿病患者角膜内皮变化的差异。患者和方法:前瞻性、纵向、配对、非随机研究,两组;第一组为糖尿病患者,第二组为非糖尿病患者。所有患者在1个月和3个月时进行了完整的眼科评估和术前和术后的镜面显微镜检查。结果:纳入119只眼。1个月时,糖尿病患者的CD损失率为11.1%,非糖尿病患者为6.3%。3个月时,糖尿病患者的损失百分比为9.9%,非糖尿病患者为5.4%。糖尿病患者的CV较高,且在1个月时具有显著性;然而,在3个月时,这些值具有可比性。糖尿病患者的HEX百分比在第一个月显著下降。结论:在M-SICS手术后1个月,糖尿病患者与非糖尿病患者相比,CD损失、CV升高和HEX降低有显著差异,但在3个月时无统计学意义。这表明糖尿病患者的角膜内皮压力更大,恢复时间更长,内皮重塑时间更长。
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