Our Summary

This study looked at whether the severity of diabetes in eye donors was associated with any changes in the density of cells in the inner layer of the cornea (endothelial cell density or ECD) and the suitability of the tissue for surgery.

They used data from over 10,000 donated eyes, grouping the donors based on their insulin use and whether they had any complications from diabetes. The groups included non-diabetic donors, diabetics not using insulin with and without complications, and diabetics using insulin with and without complications.

The results showed that 32.1% of the donors had a diagnosis of diabetes. Diabetic donors were generally older and more likely to have an artificial lens in their eye. However, the severity of their diabetes did not affect the ECD when it was adjusted for the average donor age.

Interestingly, in eyes with a natural lens, non-insulin-dependent diabetes with complications was linked with a lower chance of the eye tissue being suitable for transplant.

The researchers concluded that the severity of diabetes and having an artificial lens were not associated with a lower ECD. Non-insulin-dependent diabetes without complications was linked with a slower age-related decrease in ECD. They suggested that future studies should consider factors such as age, lens status, and their interactions when looking at ECD and transplant suitability.

FAQs

  1. Does the severity of diabetes in eye donors impact the density of cells in the inner layer of the cornea (ECD)?
  2. Is there a link between the severity of diabetes and the suitability of the eye tissue for transplant?
  3. Does having an artificial lens affect the endothelial cell density (ECD) in diabetic donors?

Doctor’s Tip

A doctor might tell a patient undergoing a corneal transplant that having diabetes does not necessarily affect the density of cells in the inner layer of the cornea. However, having complications from diabetes, especially if insulin-dependent, may impact the suitability of the eye tissue for transplant. It is important for patients with diabetes to manage their condition effectively to ensure the best outcomes for the transplant surgery. Additionally, factors such as age and lens status should be taken into consideration when assessing the suitability of the donor tissue for transplant.

Suitable For

Patients who are typically recommended for corneal transplant include those with corneal diseases such as keratoconus, Fuchs’ dystrophy, corneal scarring from injury or infection, and corneal thinning disorders. Additionally, patients with corneal edema, corneal degeneration, or corneal ulcers that do not respond to other treatments may also be candidates for a corneal transplant.

Timeline

Before corneal transplant:

  1. Patient is diagnosed with a condition such as keratoconus, Fuchs’ dystrophy, or corneal scarring that requires a corneal transplant.
  2. Patient undergoes a series of pre-operative evaluations and tests to determine the suitability for surgery, including measuring the thickness and curvature of the cornea.
  3. A donor cornea is identified and matched to the patient based on factors such as size, blood type, and tissue compatibility.
  4. The patient is placed on a waiting list for a cornea donor.
  5. Once a donor cornea becomes available, the transplant surgery is scheduled.

After corneal transplant:

  1. Patient undergoes corneal transplant surgery, which involves removing the damaged or diseased cornea and replacing it with the donor cornea.
  2. Patient is monitored closely in the immediate post-operative period for any signs of complications such as infection or rejection.
  3. Patient may experience temporary discomfort, blurred vision, and sensitivity to light in the days and weeks following surgery.
  4. Patient is prescribed eye drops and medications to prevent infection and reduce inflammation.
  5. Patient attends follow-up appointments with their ophthalmologist to monitor the healing process and ensure the success of the transplant.
  6. Over time, the patient’s vision gradually improves as the transplanted cornea integrates with the surrounding tissue.
  7. Patient may need to wear glasses or contact lenses to achieve optimal vision following the transplant.

What to Ask Your Doctor

  1. How does my diabetes diagnosis and its severity impact the suitability of corneal tissue for transplant surgery?
  2. Are there any specific precautions or considerations I should take before undergoing a corneal transplant as a diabetic patient?
  3. Will my diabetes management plan need to be adjusted or monitored more closely following the transplant surgery?
  4. Are there any potential complications or risks associated with undergoing a corneal transplant as a diabetic patient?
  5. How will my post-operative care and recovery differ as a diabetic patient compared to non-diabetic patients undergoing a corneal transplant?
  6. Are there any specific lifestyle changes or medications I should consider to optimize the success of the corneal transplant surgery as a diabetic patient?
  7. What is the expected outcome and success rate of corneal transplant surgery for diabetic patients compared to non-diabetic patients?
  8. Are there any long-term considerations or follow-up appointments I should be aware of as a diabetic patient post corneal transplant surgery?

Reference

Authors: Rand GM, Polla DJ, Patel SH, Gore PK, Forest-Smith L, Livesay TM, Chuck RS. Journal: Cornea. 2019 Oct;38(10):1203-1208. doi: 10.1097/ICO.0000000000002047. PMID: 31299666