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Impact of Diabetes Mellitus Type 2 on Donor Corneas Endothelial Cell Density
Raquel Esteves Marques, MD, Sofia Mano, MD, Filipa Caiado, MD, Paulo Guerra, MD, Ana Miguel Quintas, MD FEBO, Walter Rodrigues, MD
Corneal Endothelium; Corneal Transplantation; Diabetes Mellitus; Hyperglycemia
Introduction: Diabetic eye disease accounts for many ocular
manifestations other than diabetic retinopathy, some affecting the
ocular surface and anterior segment.
Objectives: to compare the endothelial cell density (ECD) of
donor corneas from diabetic vs. non-diabetic patients.
Methods: Retrospective study of donor corneas from a tertiary
care center. Data screening and extraction were performed from
the hospital’s Eye Bank database, specular microscopy and clinical
records from emergency department and outpatient clinic.
All consecutive donor corneas were included, given specular microscopy
had quality readings and data records were complete.
Donors were divided in two groups (diabetic and non-diabetic),
and specular microscopy data compared. Primary outcome:
ECD. Secondary outcomes: standard deviation (SD), coefficient
of variation (CV), percentage of hexagonal cells (HEX), average
cell area (AVE) and overall graft success (absence of graft
failure and rejection).
Results: 73 corneas were included, from 42 donors (39.7% females).
Mean donor age was 56 ± 11 years. Fifteen patients were
diabetic (20.5%). Mean ECD in diabetics was 2523.67 ± 299.27
cells/mm2, vs. 2528.28 ± 368.92 cells/mm2 in non-diabetics
(p=0.965). Mean SD was 126.05 ± 42.37 in diabetics vs. 134.6
± 50.12 in non-diabetic (p=0.51). CV was 32.93 in diabetic patients,
and 31.23 in non-diabetic (p0.53). HEX was comparable
in both groups, with 49.73% in diabetics and 51.04% in non-diabetics
(p=079). Diabetic donors had an AVE of 401.33μm2
vs. 404.51μm2 in non-diabetic donors (p=0.086). Overall graft
success rates were comparable between groups.
Conclusions: No significant endothelial differences were found
between diabetic and non-diabetic donors.