Is there a correlation between diabetes mellitus and central corneal thickness?

PURPOSE: To evaluate the association of central corneal thickness (CCT) with diabetes mellitus and compare it with age and sex-matched healthy controls. MATERIALS AND METHODS: This study included 245 eyes of 245 subjects (one eye per subject). One hundred diabetic patients constituted the study group and 145 were healthy controls. The study group was subdivided into 3 subgroups: subgroup 1 (no diabetic retinopathy), subgroup 2 (nonproliferative diabetic retinopathy), and subgroup 3 (proliferative diabetic retinopathy). CCT was determined with ultrasonic pachymeter. None of the patients had glaucoma, retinal laser treatment, and history of ocular surgery. Statistical analyses were performed by analysis of variance and Kruskall-Wallis tests. Correlation analysis was performed to assess the association between disease duration and glycosylated hemoglobin levels among subgroups. RESULTS: Demographic characteristics of study and control groups were similar (P>0.05). The mean CCT was significantly greater in study group (564±30 µm) compared with control group (538±35 µm) (P=0.001). In addition, mean CCT was found to be greater in subgroup 3 (582±23 µm) compared with subgroups 1 (565±32 µm) and 2 (558±31 µm); but the difference did not reach statistical significance (P=0.056). Also, there was no significant correlation in respect to the level of glycosylated hemoglobin and disease duration among the subgroups. CONCLUSIONS: We found that the central cornea of diabetic patients is thicker when compared with nondiabetic patients. Thicker central cornea associated with diabetes mellitus should be taken into consideration while obtaining accurate intraocular pressure measurements in diabetics.

Comparison of optic disc topography in non-glaucomatous eyes of children with juvenile diabetes mellitus and normal children.

PURPOSE: To compare the optic disc topography parameters of children with juvenile diabetes mellitus and normal children using the Heidelberg Retinal Tomograph (HRT III) (Heidelberg Engineering, Heidelberg, Germany). METHODS: The topographic optic disc parameters (cup volume, cup area, rim volume, rim area, disc area, mean cup-to-disc ratio, and mean cup depth) of 28 non-glaucomatous eyes of 28 children with type 1 diabetes mellitus and 28 eyes of 28 age-matched healthy children were compared using the nonparametric Mann-Whitney U test. RESULTS: No statistically significant differences were found between cup volume (P = .782), cup area (P = .878), rim volume (P = .853), disc area (P = .452), mean cup-to-disc ratio (P = .852), and mean cup depth (P = .711) of eyes of cases with diabetes mellitus and normal subjects. CONCLUSION: This result suggests that non-glaucomatous eyes of children with type 1 diabetes mellitus and healthy subjects have similar topographic optic disc characteristics.

Trabeculectomy with mitomycin C combined with direct cauterization of peripheral iris in the management of neovascular glaucoma.

PURPOSE: To determine the outcomes of trabeculectomy with mitomycin C (MMC) combined with direct cauterization of peripheral iris before iridectomy in the management of neovascular glaucoma (NVG), and to demonstrate the effect of this surgical technique on decreasing the incidence of intraoperative bleeding and early postoperative hyphema. METHODS: This prospective study was based on 72 eyes of 72 patients with NVG who underwent primary trabeculectomy with MMC combined with direct cauterization of peripheral iris before iridectomy. The patients were evaluated for intraoperative and early postoperative complications such as hyphema, and operative success rates. Operative success was defined as an intraocular pressure (IOP) < or =22 mm Hg (+/-medical therapy) in the absence of phthisis. The mean IOP and the mean number of antiglaucomatous medications at baseline and at the posttrabeculectomy sixth month were compared by paired Student t test. RESULTS: The mean preoperative IOP was 39.3+/-5.6 mm Hg (range, 29 to 60 mm Hg) whereas it was 20.02+/-4.3 mm Hg (range, 14 to 38 mm Hg) at the postoperative sixth month. The mean preoperative number of antiglaucoma medications was 3.2+/-0.4 (range, 2 to 4) but it reduced to 1.8+/-0.6 (range, 1 to 4) at the postoperative sixth month. These differences were statistically significant (P<0.00001). The IOP was < or =22 mm Hg (+/-medical therapy) in 69 eyes (95.8%) at the postoperative first week, in 62 eyes (86.1%) at the postoperative first month, in 60 eyes (83.3%) at the postoperative third month and in 48 eyes (66%) at the postoperative sixth month. Hyphema occurred in 15 eyes (20.8%) within the first week of the surgery. In 12 eyes it was transient; however, in 3 eyes irrigation of anterior chamber was required. CONCLUSIONS: Trabeculectomy with MMC combined with direct cauterization of peripheral iris decreases the incidence of both intraoperative bleeding, and early postoperative hyphema, and provides reduction of IOP and the number of antiglaucomatous medications in cases with NVG in a 6-month follow-up period.