Corneal Biomechanical Changes After Uneventful Phacoemulsification in Patients With Type 2 Diabetes Mellitus and Patients Without Diabetes

Autores da FMUP

• João Nuno Bicho Beato

  Autor

• Manuel Alberto De Almeida E Sousa Falcão

  Autor

• Angela Maria Veloso Guimarães Carneiro

  Autor

• Fernando Manuel Mendes Falcão Reis

  Autor

Participantes de fora da FMUP

• Esteves Leandro, J
• Reis, D
• Rosas, V

Unidades de investigação

• Cirurgia e Fisiologia

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Purpose: To compare corneal biomechanical changes after uneventful phacoemulsification cataract surgery between type 2 diabetic (DM) and nondiabetic patients. Methods: Forty-four diabetic (44 eyes) and 44 (44 eyes) age and sex-matched non-DM controls with age-related cataract were enrolled in this prospective observational study. Corneal hysteresis (CH), corneal resistance factor (CRF), and corneal-compensated intraocular pressure (IOPcc) were evaluated by using the ocular response analyzer; central corneal thickness was recorded by using the Pentacam HR. Patients were evaluated preoperatively and 1 and 6 months after surgery. Results: In the DM group, CH was observed to be significantly lower than preoperative value (9.8 +/- 1.5 mm Hg) at 1 month (9.4 +/- 1.2 mm Hg,P= 0.040), but not at the 6-month follow-up (9.6 +/- 1.6 mm Hg,P= 0.437),whereas it did not change significantly in the non-DM group (preoperative 9.8 +/- 1.3 mm Hg vs. 1 month 9.6 +/- 1.1 mm Hg vs. 6 months 10.1 +/- 1.1 mm Hg,P> 0.05). CRF was significantly lower than the preoperative values at 1 and 6 months in both groups (P <= 0.001). Postoperative CH change was significantly associated with preoperative CH (P< 0.001), preoperative IOPcc (P= 0.004), and IOPcc change (P< 0.001), whereas CRF change was only correlated with preoperative CRF (P< 0.001). There was a significant postoperative IOPcc reduction 6 months after surgery (P< 0.001) in both DM and non-DM groups; however, central corneal thickness was not found to significantly change in the postoperative period (P> 0.05). Conclusions: This study showed that phacoemulsification causes a significant and persistent decrease in intraocular pressure and CRF in both groups, whereas CH recovered to preoperative values, although more slowly in patients with diabetes.

Keywords

• corneal biomechanics; diabetes mellitus; intraocular pressure; phacoemulsification