Comparison of endothelial cell loss in diabetic patients after conventional phacoemulsification and femtosecond laser-assisted cataract surgery

• Published in: BMC ophthalmology Vol. 23; no. 1; pp. 181 - 7
• Main Authors: Cruz, João Carlos Gonçalves, Moreno, Celso Busnelo, Soares, Paula Virginia Brom Dos Santos, Moscovici, Bernardo Kaplan, Colombo-Barboza, Guilherme Novoa, Colombo-Barboza, Luiz Roberto, Colombo-Barboza, Marcello Novoa
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26.04.2023; BioMed Central; BMC
• Subjects: Care and treatment; Cataract; Cataract - complications; Cataract Extraction; Cataracts; Cell density; Clinical trials; Comparative analysis; Cornea; Corneal endothelium; Data collection; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetics; Edema; Endothelial Cells; Endothelium; Eye surgery; Humans; Intraocular lenses; Laboratories; Laser Therapy; Lasers; Morphology; Ophthalmology; Patients; Phacoemulsification; Quasi-experimental methods; Surgery; Tomography; Type 2 diabetes; Type 2 diabetes mellitus; Visual acuity; Fort Worth Texas; Brazil; United States > US; Germany; Cataract; Cataract extraction; Phacoemulsification; Type 2 diabetes mellitus; Corneal endothelium
• ISSN: 1471-2415; 1471-2415
• DOI: 10.1186/s12886-023-02923-3

This study aims to comparatively evaluate the morphological changes of the cornea after phacoemulsification (PHACO) and femtosecond laser-assisted cataract surgery (FLACS) without intercurrences in patients with type 2 diabetes mellitus. A total of 95 diabetic patients with moderate cataracts (N2 + and N3+), 47 undergoing PHACO and 48 undergoing FLACS, were selected randomly for the study. Surgeries were performed by a single surgeon between July 2021 and December 2021. Cumulative dissipated energy (CDE) and total balanced saline solution (BSS) data were obtained at the end of each surgery. Changes in corneal endothelial cell density (ECD) and central corneal thickness (CCT) at three months postoperatively were investigated. After three months, evidence is lacking between groups in the CCT measures; the difference was neither statistically nor clinically relevant. However, for ECD, a significant and clinically significant difference was found; if all patients were treated with laser, the mean ECD would be 423.55 greater (RSE: 86.09; p-value < 0.001; 95% CI: 254.81-592.29) than the ECD potential means of 1656.423 among the conventional group (RSE: 74.90; p-value < 0.001; 95% CI: 1509.62-1803.23). Diabetic patients under treatment with moderate cataracts may predispose themselves to a more significant loss of endothelial cells after conventional phacoemulsification than femtosecond laser-assisted cataract surgery. It was registered at The Brazilian Registry of Clinical Trials (ReBEC) with the code RBR-6d8whb5 (UTN code: U1111-1277-6020) on 17/05/2022.