Purpose: Diabetic keratopathy, an ocular complication of diabetes mellitus, impairs tear secretion and corneal sensation. However, there are still many unknown factors concerning this condition. The aim of this study is to compare preoperative corneal findings and postoperative course between patients with and without diabetes undergoing vitrectomy.
Subjects and methods: We examined tear secretion volume using Schirmer'sI test, corneal sensation using Cochet-Bonnet esthesiometer, and corneal endothelial cell density preoperatively in a series of age-matched and sex-matched eyes of patients with and without diabetes (n=104 each from consecutive 575 eyes) who underwent vitreous surgery between February 2014 and February 2016 at our hospital. We excluded the eyes of patients who were using glaucoma eye drops, dry-eye eye drops, or contact lenses. Eyes with an abnormal ocular surface, positive fluorescein staining, or history of ocular surgery within the past 6 months were also excluded. We also examined the onset of persistent corneal epithelial defect after vitreous surgery.
Results: In the eyes of patients with diabetes, tear secretion volume was significantly lower (p=0.040)and corneal sensation was significantly lower (p=0.0018) than in those without diabetes. Corneal endothelial cell density in the eyes of patients with and without diabetes was not different (p=0.12). Persistent corneal epithelial defect was observed in eight eyes of patients with diabetes, whereas was absent in those without diabetes (p=0.0068).
Conclusions: The eyes of patients with diabetes showed significantly decreased tear secretion and corneal sensation. These results suggested that despite normal findings according to slit lamp microscopy, the diabetic ocular surface may have subclinical abnormalities.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 365-371, 2018.