Posters

Influence of topical Dexamethasone on morphological characteristics of corneal endothelium in diabetic and nondiabetic patients after cataract surgery

Poster Details

First Author: A.Viteri SPAIN

Co Author(s):    A. Viteri   D. Galarreta   D. Peña   J. Herreras   M. Lopez   L. Manzanas     

Abstract Details

Purpose:

To evaluate the morphological changes of corneal endothelium (CE) after cataract surgery in control subjects and patients with Type 2 Diabetes (T2D) without retinopathy, and to determine if topical Dexamethasone (DXM) prior to surgery may affect those characteristics.

Setting:

Phacoemulsification surgery causes a decrease in CE cellularity. Compensating mechanisms alter the shape and size of the remaining cells. Furthermore, cells migrate to cover damaged locations. Non-contact specular microscope is useful to obtain information about endothelial cell density (ECD), coefficient of variation (CV), hexagonality percentage(HP) and central pachymetry (CCT).

Methods:

Prospective, interventional clinical study. Eighty eyes of eighty patients were included and divided into four groups, all of them received treatment two-hourly 48 hours prior to surgery. Forty control eyes, of which 20 were treated with topical saline (G1) and 20 with DXM (G3). Forty eyes of T2D patients were divided the same way: 20 eyes received saline treatment (G2) and 20 topical DXM (G4). Endothelial evaluation was performed by the non-contact specular microscope. Phacodynamics from Infiniti© phaco system were registered to be sure of being affected by the same energy. Data obtained were: ECD, CV, HP, and CCT.

Results:

All the groups received the same amount of energy. No differences in phacodynamics from Infiniti© phaco system were registered among groups (P>0,05). Statistically significant differences (SSD) were found between V0 (prior to surgery) and V3 (six months after surgery) in the next measures. ECD in G1 (VO=2614,42±319,46, V3=1918,37±535,69; p<0,01), G2 (VO=2546,56±364,62, V3=1883,00±615,98; p<0,001), G3 (VO=2553,81±272,59, V3=2019,19±428,36; p<0,001), G4 (VO=2528,57±389,16, V3=1967,48±427,55; p<0,001). CCT in G1 (V0=524,89±36,47, V3=518,11±38,31; p=0,025). HP in G3 (V0=54,56±6,22, V3=48,25±8,23; p=0,036), G4 (V0=54,67±7,16, V3= 48,00±11,16; p=0,012). No SSD were found from V0 to V3 between groups.

Conclusions:

The decrease in ECD and changes in the morphology of corneal endothelium showed no clinical relevance. Changes were not influenced by the presence of diabetes or the instillation of dexamethasone. Possible molecular changes have not morphological evidence. The influence of energy seemed to have more power than other factors.

Financial Disclosure:

None