Effects of adrenalin on corneal endothelium in patients with diabetic cataract

doi:10.3969/j.issn.1002-7386.2014.03.005

Abstract：Objective To investigate the effects of adrenalin on corneal endothelium after phacoemulsification in patients with diabetic cataract and to explore the clinical suitable concentration of adrenalin during the operation .Methods Ninety patients with diabetic cataract (90 eyes) who were enrolled in our hospital from January 2013 to June 2013 were randomly divided into three groups,with 30 eyes in each group.These patients received phacoemulsification after the irrigation solution was added with different concentrations of adrenalin (0.1ml,0.2ml,0.5ml).At 1 week before and after the operation the corneal endothelial density and the percentage of hexagonal cells were detected by non -contact corneal endothelium microscope.Results There were no significant differences in the preoperative corneal endothelial cell density and percentage of hexagonal cells among the three groups ( P >0.05).However one week after surgery ,the cell densities in 0.1ml group, 0 .2 ml group and 0.5 ml group were (2493.52 ±285.32)/mm 2 ,(2428.14 ±353.53)/mm 2 ,(2379.51 ±375.13)/mm 2 , respectively,and the percentage of hexagonal cells was (48.88 ±13.13)/mm 2 , (44.77 ±12.67 )/mm 2 , ( 43.44 ± 13.99)/mm 2 ,respectively.Both cell density and percentage of hexagonal cells one week after surgery were significantly lower than those before operation, there were significant differences among three groups ( P <0.05).After operation the two detection parameters in three groups were gradually decreased with the increase of adrenalin concentration ,but there were no significant differences among three groups ( P >0.05).Conclusion The tolerance of corneal endothelial cell to surgery injure and adrenalin toxicity is decreased in patients with diabetic cataract .The lower concentration of adrenalin should be used in phacoemulsification so as to reduce the damage to corneal endothelial cell during maintaining mydriasis state .