Ocular surface changes and corneal epithelial remodeling after cataract surgery in patients with type 2 diabetes: a case-control study.

BACKGROUND

Diabetes affects one out of ten adults in the world and impacts all structures of the eye. Lens opacification is one of the leading causes of visual impairment in diabetic patients. Diabetes is also a major risk factor for dry eye syndrome. The aim of the study was to evaluate changes in the ocular surface and the corneal epithelium after cataract surgery in patients with type 2 diabetes.

METHODS

Patients scheduled for cataract surgery were included consecutively in two groups: diabetes and control. Parameters evaluated were: Ocular Surface Disease Index (OSDI), Tear Break-Up-Time (TBUT), Oxford score, corneal total thickness, and central, superior and inferior epithelial thickness, before surgery and one month postoperatively. A secondary analysis divided diabetic patients into two subgroups according to the duration of diabetes (more or less than ten years).

RESULTS

Forty-four eyes of 30 diabetic patients and 79 eyes of 50 control patients were analyzed. Preoperative ocular surface parameters did not differ between the two groups. After surgery, diabetic patients had higher OSDI scores than before surgery (p = 0.047) and the control group (p = 0.023), as well as an increase in total corneal pachymetry (p = 0.003). TBUT and Oxford score did not differ between groups (p = 0.291 and p = 0.642). Patients with diabetes for more than 10 years had a higher OSDI preoperatively (p = 0. 030) and postoperatively (p = 0.026) than the other two subgroups. After surgery, patients with diabetes for more than ten years showed central epithelial thinning (p = 0.040).

CONCLUSION

Patients with type 2 diabetes present more dry eye symptoms after cataract surgery, with a greater effect in those whose diabetes has been progressing for more than 10 years.

STUDY REGISTRATION

NCT06638424; 2024-10-09 (retrospectively registered).