AIM: To observe the changes of corneal endothelium in diabetes patients before and after cataract phacoemulsification surgery with confocal microscopy for exploring the variation and influencing factors.

METHODS: Phacoemulsification were randomly divided into 50 aged-related cataract patients with diabetes mellitus(56 eyes, diabetes group)and 50 patients with senile cataract(60 eyes, control group). Cataract phacoemulsification and intraocular lens implantation were performed, central corneal thickness, the corneal endothelial cell density, coefficient of variation and percentage of hexagonal cell were measured before surgery, 1 week, 1 month and 3 months after surgery by confocal microscopy.

RESULTS: Before surgery, there was no statistical difference between the two groups of central corneal thickness, corneal endothelial cell density, coefficient of variation and percentage of hexagonal cell(P>0.05). Compared with pre-operation, the central corneal thickness and coefficient of variation were increased post-operation, but the corneal endothelial cell density and percentage of hexagonal cell decreased gradually. The central corneal thickness of diabetes group was more significantly than control group 1 week, 3 months after surgery(P<0.05), and the corneal endothelial cell density was less significantly than control group(P<0.05). One week, 3 months after surgery, the percentage of hexagonal cell was less than control group(P<0.01). The coefficient of variation was significantly higher than control group(P<0.01).

CONCLUSION: Aged-related cataract patients with diabetes mellitus were much more poor tolerability on cataract phacoemulsification surgery. Compared with senile cataract patients, the corneal endothelium injury was more serious and the velocity and validity of recovery were lower comparatively.