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Sonmez, B. et al.

Effect of glycemic control on refractive changes in diabetic patients with hyperglycemia.

PURPOSE: To investigate the effect of intensive glycemic control on hyperglycemia- induced changes in refraction, corneal topography, lenticular and corneal thickness in diabetic patients. METHODS: Eighteen diabetic patients with plasma glucose >300 mg/dl were enrolled in the study consecutively. Autorefraction, C-Scan corneal topography, Javal keratometry, corneal pachymetry and ultrasonic biometric measurements were carried out at presentation and after metabolic control of blood sugar (plasma glucose profile <200 mg/dl). One eye of each patient was selected randomly for statistical analysis. RESULTS: Mean plasma glucose levels were 356.00 mg/dl before and 133.78 mg/dl after treatment. The median values of the autorefractometric measurements were - 0.125 D on admission and + 0.375 D at the second examination. The difference in the refraction was statistically significant (P = 0.022). Nine of 18 patients became hyperopic, 2 became myopic and 7 showed no change after treatment. There was a significant change in the corneal topographic keratometric measurements at the flattest corneal meridian after treatment (P = 0.037). After treatment no statistically significant changes were observed in the pachymetric corneal thickness, anterior chamber depth, biometric dioptric lens calculations and Javal keratometric data. CONCLUSIONS: Hyperglycemia is the major cause of the transient refractive changes in diabetic patients. Following intensive medical treatment, a considerable number of patients tend to become more hyperopic compared with the hyperglycemic state. During the treatment period, changes in the corneal topographic parameters might be a potential source of error for keratorefractive and cataract surgery.[1]

References

Effect of glycemic control on refractive changes in diabetic patients with hyperglycemia. Sonmez, B., Bozkurt, B., Atmaca, A., Irkec, M., Orhan, M., Aslan, U. Cornea (2005) [Pubmed]

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