A Novel Approach to Prevent Endothelial Tear/Detachment in Combined Advanced Pseudoexfoliation Syndrome and Diabetes Mellitus

Objective: To find a novel way to prevent endothelial tear/detachment during phacoemulsification in pseudoexfoliation combined with diabetes mellitus undergoing phacoemulsification. Introduction: The cornea is lined by only one layer of hexagonally shaped, uniformly sized cells internally, which is called the endothelium. The endothelium can be affected by many factors, like the aging process, pseudoexfoliation (PXF) and diabetes millets. The combination of more than two factors could have a loosening effect on the endothelial attachment to its basement membrane. Subject and method: The current study is an interventional clinical trial one, which comprises of 43 patients with 84 eyes. All of them had diabetic retinopathy and pseudoexfoliation. They divided into three groups: Group A a clear corneal incision for the side port and the main incision done. Group B both incisions performed at the limbus. Group C scleral tunnel for both incisions. Result: The age of the groups was 58–83 years with a mean of 70.5 years. The gender distribution was 10.7% males and 89.3% females, but the p-value showed non-significant p-value between the gender distribution and both the tear and detachment. Group A endothelial detachment in the main incision and tear at the side ports. Group B endothelial tear both side ports and main incision. Group C neither tear nor detachment happened in almost all cases. Conclusion: The study has shown that combined Advanced PEX and DM carries a very high risk for endothelial damage; therefore, scleral tunnel instead of all the corneal incisions provides a novel approach to prevent endothelial tear/ detachment in such cases.

Author(s):

Omer Othman Abdullah

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