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Isaac Marco Chocron, Dinesh Rai, Jimmy Yan Hu, Gabriel Rand, Nicole Bernstein, Jimmy Lee, Moonseong Heo, Ji Won Kwon, Roy S Chuck; Effect of Diabetes Mellitus and Metformin on Central Corneal Endothelial Cell Density in Eye Bank Eyes. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2888.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluating the effect of systemic conditions and long-term medications on eye bank eyes provides useful information on tissue suitability for transplantation. In this retrospective study we sought to determine whether metformin use and diabetes mellitus affect central corneal endothelial cell density (ECD) in an eye bank corneal donor database.
The Lions Eye Institute corneal donor database consisting of 37,330 corneas (collected from July 2007 to May 2015) was examined. Analyses were conducted to ascertain the impact of metformin use and diabetes mellitus (DM) on central corneal endothelial density (ECD). Associations of ECD with metformin use, and DM were tested by mixed effects linear models that take into account correlations of outcomes between eyes within subjects adjusting for age, IOL status, and glaucoma. Subjects (N=17,056) with observed ECD counts for both eyes are included for the analysis.
Average donor age was 56.3 (SD=15.0). There were N=11,020 (64.6%) males and N=6,036 (35.4%) females. Mean Corneal ECD was 2,593 (SD=438) for the right eye and 2,590 (SD=438) for the left eye. Metformin use was not associated with ECD (model-based M±SE = 2,592±11.9 (N=1,014) for use vs. 2,592±3.0 (N=16,042) for non-use, p=0.302) after adjusting for age, IOL status, and glaucoma; further stratified analysis showed that metformin use was not associated with ECD in either diabetics or non-diabetics. However, metformin use was significantly associated with a lower ECD among glaucoma patients after adjusting for age, IOL status, and diabetes mellitus: (2,658 ±50.7 (N=27) for use vs. 2,789 ±19.0 (N=164) for non-use, p=0.018). The presence of DM was significantly associated with lower ECD (2,581±5.6 (N=4,766) for DM vs. 2,595±3.4 (N=12,290) for non-DM, p=0.031) after adjusting for age, IOL status, and glaucoma.
The presence of diabetes mellitus was significantly associated with lower ECD. Metformin use was not associated with ECD with the exception of patients with glaucoma, in which subgroup analysis showed a lower ECD. Nonetheless, the differences in ECD observed were small and unlikely to affect the suitability for transplantation of donor corneas.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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