Changes in Corneal Characteristics, Anterior Chamber Depth, and Ocular Pressure after Phacoemulsification among Diabetic and Non-diabetic Adults

The objective of this study was to assess the effects of phacoemulsification on Corneal Endothelial Cell (CEC) characteristics, Central Corneal Thickness (CCT), Anterior Chamber Depth (ACD), and Intraocular Pressure (IOP), and compare them between diabetic and non-diabetic adults.

An observational hospital-based study was conducted, including patients referred for phacoemulsification surgery between September 2019 and April 2021 at the Al-Neelain University Eye Hospital in Sudan who met the selection criteria. The selection criteria were normal CCT (500 to 600 μm), IOP ranging from 10 to 21 mmHg, ACD > 2 mm, Endothelial Cell Density (ECD) ≥ 1000, no active ocular pathology, and no refractive surgeries or contact lens use. Pre- and six-week post-operative measurements included endothelial cell parameters, CCT, ACD, and IOP.

A total of 180 patients (180 eyes) were divided into non-diabetic (n=97, 53.89%; mean age 61.7±7.52 years) and diabetic (n=83, 46.11%; mean age 61.4±6.78 years) groups. Significant changes were observed in both groups after surgery. The average changes for non-diabetic and diabetic patients, respectively, were as follows: decreased ECD (mm³) from 2301.44±322.71 to 1907.25±1455.82, and from 2434.47±188.2 to 1432.2±350.5; increased average cell size from 438.63±77.07 to 630.27±206.02 and from 406.3±73.8 to 639.7±255.7; increased coefficient variation in cell size (%) from 39.87±6.63 to 28.48±24.70 and from 39.8±5.80 to 27.6±16.7; decreased cell number (mm²) from 66.0±29.54 to 43.52±30.93 and 68.3±21.6 to 44.7±15.6 to 43.52±30.93; increased CCT (µm) from 483.2±38.7 to 512.4±53.5; and increased ACD (mm) from 2.71±0.24 to 3.16±0.23 and from 2.80±0.22 to 3.18±0.17.

Diabetic patients demonstrated variable changes compared to their non-diabetic counterparts post-phacoemulsification. Changes in both groups included endothelial cell loss, increased CCT and ACD, and decreased IOP, with more pronounced effects observed in diabetic patients. In the future, these findings will help cataract surgeons anticipate changes in these parameters after phacoemulsification.