Background: Diabetics have abnormal corneal morphology along with higher rate of corneal endothelial cell loss and decreased corneal endothelial cell density and early onset of cataract

Aim:To evaluate the corneal endothelial cell density, central corneal thickness and coefficient of variation in patients with type 2 diabetes mellitus before and after phacoemulsification  and SICS with  intraocular lens implantation and to compare them with the age–matched non–diabetic patients.

Material and method :Fifty eyes of  50 patients with Type 2 diabetes mellitus and 50 eyes of 50 age matched healthy patients underwent MSICS and Phacoemulsification were evaluated. All the patients underwent specular microscopy for the corneal endothelial cell count of cornea and central corneal thickness pre–operatively, first post operative day ,at one week, and  six weeks post–operatively. The morphology, variation in the endothelial size and shape and percentage of hexagonal cells were assessed.

Observation and results:The mean pre–operative endothelial count in the control was higher than the diabetic group (p<0.001). The post–operative endothelial count loss in all the 4 groups were statistically significant (one–way ANOVA p<0.001). On comparing post–operative endothelial loss in non diabetics  to diabetic group, the diabetic undergoing phaco had significantly higher endothelial loss (10.52% P value 0.0001) as compared to diabetic undergoing SICS (6.38%). There was also a significant difference  in central corneal thickness pre operatively in diabetics as compared to control . On comparing post–operative central corneal thickness in non diabetics  to diabetic group, the diabetic undergoing phaco had significantly greater increase in CCT (3.46%) as compared to diabetic undergoing SICS( 3.32% P value 0.004).The change in percentage hexagon cells in diabetic group was significantly higher than in non diabetic group. Inter group change in coefficient of variance was not statistically significant

Conclusion: Compared to non–diabetic patients, diabetic patients have more endothelial cells damage after phacoemulsification. Corneal endothelial evaluation of diabetic patients is recommended before any intraocular surgery.