Epithelial Remodeling Following Phacoemulsification in Diabetic Patients Using Anterior-Segment Optical Coherence Tomography: A Comparative Study

Purpose: To compare the effect of phacoemulsification on corneal epithelial thickness in diabetic and nondiabetic cataract patients. Methods: Fifty eyes with cataracts were enrolled in a prospective comparative interventional study. They were divided into two groups: group A (diabetics) and group B (nondiabetics) and underwent uneventful phacoemulsification. Epithelial thickness was assessed in the central, paracentral, and peripheral cornea on the first day and at 1 week, 1 month, and 3 months postoperatively using spectral-domain ocular coherence tomography. Results: A significant increase in the first-day postoperative central epithelial thickness was noticed in both groups (57.16± 3.5 μm and 55.96± 2.81 μm in groups A and B, respectively), with increased baseline epithelial thickness of 3.8± 2.1 μm and 3.4± 2.14 μm in groups A and B, respectively ( P < 0.001). A significant decrease in epithelial thickness was noticed in both groups after 1 week (− 2.40± 3.1 μm and − 2.76± 2.71 μm in group A and B, respectively). No further significant change was noticed in the nondiabetic group at 1 month; however, significant reductions in for central epithelial thickness were found in the diabetic group up to the first month (− 0.80± 1.9 μm, P =0.05). Central corneal thickness followed the same pattern of change as the epithelium. A nonsignificant delay in visual acuity improvement was noticed in diabetic patients. Conclusion: Phacoemulsification induces a temporary increase in corneal and epithelial thickness that should resolve by the first week postoperatively. However, diabetic patients had slower epithelial recovery that took up to 1 month, which could be reflected in delayed visual recovery with no effect on the final visual outcome.