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

Abstract 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 ch...

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Main Authors: Emilia Koestel, Léa Dormegny, Arnaud Sauer, David Gaucher, Tristan Bourcier
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-04178-6
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author Emilia Koestel
Léa Dormegny
Arnaud Sauer
David Gaucher
Tristan Bourcier
author_facet Emilia Koestel
Léa Dormegny
Arnaud Sauer
David Gaucher
Tristan Bourcier
author_sort Emilia Koestel
collection DOAJ
description Abstract 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).
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spelling doaj-art-ed638410b58949aeb6650cf110f52f782025-08-20T03:03:41ZengBMCBMC Ophthalmology1471-24152025-07-0125111110.1186/s12886-025-04178-6Ocular surface changes and corneal epithelial remodeling after cataract surgery in patients with type 2 diabetes: a case-control studyEmilia Koestel0Léa Dormegny1Arnaud Sauer2David Gaucher3Tristan Bourcier4Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, University of StrasbourgDepartment of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, University of StrasbourgDepartment of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, University of StrasbourgDepartment of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, University of StrasbourgDepartment of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, University of StrasbourgAbstract 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).https://doi.org/10.1186/s12886-025-04178-6Cataract surgeryCorneal epitheliumDiabetesDry eye - Ocular surface
spellingShingle Emilia Koestel
Léa Dormegny
Arnaud Sauer
David Gaucher
Tristan Bourcier
Ocular surface changes and corneal epithelial remodeling after cataract surgery in patients with type 2 diabetes: a case-control study
BMC Ophthalmology
Cataract surgery
Corneal epithelium
Diabetes
Dry eye - Ocular surface
title Ocular surface changes and corneal epithelial remodeling after cataract surgery in patients with type 2 diabetes: a case-control study
title_full Ocular surface changes and corneal epithelial remodeling after cataract surgery in patients with type 2 diabetes: a case-control study
title_fullStr Ocular surface changes and corneal epithelial remodeling after cataract surgery in patients with type 2 diabetes: a case-control study
title_full_unstemmed Ocular surface changes and corneal epithelial remodeling after cataract surgery in patients with type 2 diabetes: a case-control study
title_short Ocular surface changes and corneal epithelial remodeling after cataract surgery in patients with type 2 diabetes: a case-control study
title_sort ocular surface changes and corneal epithelial remodeling after cataract surgery in patients with type 2 diabetes a case control study
topic Cataract surgery
Corneal epithelium
Diabetes
Dry eye - Ocular surface
url https://doi.org/10.1186/s12886-025-04178-6
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AT arnaudsauer ocularsurfacechangesandcornealepithelialremodelingaftercataractsurgeryinpatientswithtype2diabetesacasecontrolstudy
AT davidgaucher ocularsurfacechangesandcornealepithelialremodelingaftercataractsurgeryinpatientswithtype2diabetesacasecontrolstudy
AT tristanbourcier ocularsurfacechangesandcornealepithelialremodelingaftercataractsurgeryinpatientswithtype2diabetesacasecontrolstudy