Corneal Abnormalities in Diabetest
JANPEN SIRIBUNKUM, M.D.*, PANIDA KOSRIRUKVONGS, M.D.**, API CHART SIN GALA V ANUA, M.D.**
Affiliation : * Department of Ophthalmology Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, ** Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok I 0700, Thailand. t Presented at the Royal College of Ophthalmologists of Thailand Annual Meeting, Cha-am, Petchburi, July 16, 2000.
Objective : To compare corneal thickness and endothelial morphology in patients with dia betes mellitus and age-matched normal subjects, and to determine whether the duration of diabetes mellitus, severity of diabetic retinopathy, and glycemic control are correlated with these measure ments.
Design : Single center, case-control study. Participants : Sixty eyes of thirty diabetic patients and sixty eyes of thirty healthy non diabetic subjects were studied.
Intervention : Corneal thickness was measured by ultrasonic pachymeter. Corneal endo thelial morphology was examined with a contact specular microscope.
Main outcome measures : Corneal endothelial cell density, mean cell area, coefficient of variation, percentages of hexagonal cells, and corneal thickness were measured.
Results : There was statistically significant increased corneal endothelial cell density and decreased mean endothelial cell area in the diabetic patients. The diabetic corneas had an increased coefficient of variation of endothelial cell area, a decreased percentage of hexagonal endothelial cell and an increased corneal thickness compared with the control subjects, but these differences were not statistically significant. The duration of diabetes mellitus was significantly correlated with pleo morphism, polymegathism and corneal thickness. Severity of diabetic retinopathy was correlated with endothelial cell density, but these correlations were low. The corneal changes were not cor related with glycemic control.
Conclusions : The diabetic corneas tended to be thicker and had more pleomorphism and polymegathism, though this was not statistically significant. Duration of diabetes mellitus correlated significantly with these corneal changes. This suggests that corneal changes should be evaluated and confirmed before intraocular surgery in chronic diabetic patients.
Keywords : Corneal Endothelial Cell Density, Coefficient of Variation, Pleomorphism, Polymegathism, Corneal Thickness, Diabetes Mellitus.
