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Corneal Endothelial Morphology and Cell Density Changes from Type 2 Diabetes and Smoking

Title of Article: Effects of Type 2 Diabetes Mellitus and Smoking on Changes in Corneal Endothelial Morphology and Cell Density

What are the key takeaway points from this article?

The goal of this study was to assess the corneal endothelial morphology and cell density of diabetic smokers and non-smokers in comparison with 50 to 70 age-matched healthy subjects. The study aimed to determine whether smoking increases the effects of type 2 diabetes mellitus (DM) on corneal morphologic parameters. This study was a prospective cohort study. 200 (89 females and 111 males) patients were recruited and were divided equally in the following 4 groups: 1) Smokers with type 2 DM, 2) Non-smokers with type 2 DM, 3) Non-diabetic smokers, and 4) Non-diabetic non-smokers (control group). One experienced ophthalmic technician examined all eyes with a non contact specular microscope. Photographs of at least 100 visible endothelial cells were marked manually with mouse clicks. Minimum, maximum, and average cell size (AVG); endothelial cell density (ECD); SD of mean cell area (SD); and percentage of hexagonal cells (HEX) (%) of the endothelial cell layer were calculated using the built-in software.

The study found that smokers without DM and smokers with DM had a lower ECD compared with the control group and with the non-smokers with DM. Furthermore, the central corneal thickness (CCT) was increased in the diabetic smokers group compared with the control group (P=0.013). The results of this study affirmed that having DM and smoking causes an increase in CCT and decrease in ECD. Additionally, smoking cigarettes has worse consequences on corneal endothelial cells than DM on its own.

Publication Date: October 2022

Summary by: : Maya Alik

Reference: Antičić-Eichwalder M, Lex S, Sarny S, Schweighofer J, Marić I, El-Shabrawi Y.

Effects of Type 2 Diabetes Mellitus and Smoking on Changes in Corneal Endothelial

Morphology and Cell Density. Cornea. 2022;41(10):1255-1259.



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