RESEARCH ARTICLE


Evaluation of Corneal Endothelium after Myopic Laser-Assisted In Situ Keratomileusis (LASIK) with Accelerated Cross-Linking (CXL) in Diabetic Patients



Mohamed Salah El-Din Mahmoud1, *, Ebtesam E. Hassan2, Ahmed S. Abdelhalim1
1 Department of Ophthalmology, Faculty of Medicine, Minia University, Minia, Egypt
2 Department of Public Health, Faculty of Medicine, Minia University, Minia, Egypt


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Creative Commons License
© 2021 Mahmoud et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Ophthalmology, Faculty of Medicine, Minia University, Minia, Egypt; Tel: 01003321802; E-mail: Mohamed_Zaki@mu.edu.eg


Abstract

Purpose:

To study the effect of LASIK with accelerated CXL on corneal endothelium in myopic diabetic patients.

Methods:

A prospective comparative interventional case series study on 120 eyes of 60 myopic patients treated with LASIK with accelerated CXL. They were divided into two groups; group A included 60 eyes of diabetic patients, group B included 60 eyes of non-diabetic patients. Corneal endothelium was evaluated by specular microscope preoperatively and after 3 and 6 months postoperatively.

Results:

The endothelial cells density (ECD) showed statistically significant changes after 3 and 6 months postoperatively (p-value <0.001) in group A while group B showed statistically significant changes after 3 months without significant change after 6 months (p-value= 0.103), both groups had improved to near preoperative levels, with no significant differences between them at the end of 6 months follow-up (p-value = 0.219). Regarding pleomorphism, there was a significant change in group A during 6 months follow-up (p-value <0.001) with no significant change in group B (p-value= 0.884), and in comparing both groups, there was a significant change at the end of 6 months follow-up (p-value <0.001). Regarding polymegathism, there was a significant change in group A during 6 months follow-up (p-value <0.001) with no significant change in group B after 3 (p-value= 0.178) and 6 (p-value= 0.866) months follow-up, and in comparing both groups, there was a significant change at the end of 6 months follow-up (p-value <0.001).

Conclusion:

LASIK with accelerated CXL is safe on corneal endothelium in diabetic myopic patients but needs to follow up for a long period.

Keywords: Lasik, Corneal endothelium, Accelerated cross-linking, Diabetes mellitus, Diabetic patients, In situ.