Comparative Analysis of Endothelial Cell Density and Central Corneal Thickness Following Cataract Surgery in Patients with and without Diabetes

Background: This study aimed to compare corneal endothelial cell count density, morphology, and central corneal thickness (CCT) changes in diabetic versus non-diabetic patients undergoing cataract surgery.Methods: A prospective study included 30 diabetic and 30 non-diabetic patients aged 40-70 years undergoing small incision cataract surgery.Diabetic patients were assessed based on HbA1C levels, diabetes duration, insulin dependency, and retinopathy grades.Specular microscopy was conducted preoperatively and 4 weeks postoperatively to evaluate endothelial parameters.Results: In diabetic patients, 4 weeks post-surgery, mean endothelial cell density (ECD), coefficient of variance (CV), CCT, and hexagonality were 1595.93 cells/mm 2 , 45.13%, 518.67 µm, and 35.43%, respectively.Non-diabetic patients showed 1929.97 cells/mm2 values, 40.37%, 493.67 µm, and 43.17%, respectively.Statistically significant differences were observed in ECD, CCT, and morphological parameters between diabetic and non-diabetic groups (P<0.001).No significant differences were found in endothelial parameters between diabetic patients with HbA1c levels <7.5% and >7.5% at 4 weeks post-surgery.Conclusion: Diabetic patients exhibited significantly higher corneal endothelial cell changes than non-diabetic patients.ECD loss, increased CV%, and mean CCT were more pronounced in diabetic patients.Hexagonality percentage was lower in diabetic patients.These alterations mimic those seen with aging.Additionally, diabetic patients showed slower endothelial healing compared to non-diabetic counterparts following cataract surgery.