目的：探讨2型糖尿病白内障患者角膜内皮细胞(CEC)及核密度(ND)的特征，并评估血糖相关指标的影响。

方法：纳入2023年7月至2024年7月在我院行白内障手术的患者187例187眼，采用非接触式镜面显微镜测量CEC，通过IOLMaster 700测量ND。根据糖化血红蛋白(HbA1c)和空腹血糖(FBG)水平对187名参与者进行分层。采用相关性分析和多元线性回归分析阐明糖尿病状态与眼部参数之间的关联。测量52名参与者房水中抗坏血酸(AA)的浓度。

结果：与对照组相比，糖尿病组最大内皮细胞大小增大、内皮细胞密度(ECD)减小、六边形细胞比例降低、ND增大以及角膜顶点等效球面度数(Scv)降低(P<0.05)。相关性分析结果显示，CEC和ND的变化与空腹血糖(FBG)、糖化血红蛋白(HbA1c)水平及糖尿病病程显著相关(P<0.05)。在52名参与者中，糖尿病患者房水中的AA水平较低，表明抗氧化能力减弱。

结论：糖尿病状态可显著影响白内障患者的角膜最大细胞大小、六边形细胞比例及ND，这可能与房水中总抗氧化能力下降有关。

METHODS: A total of 187 cases(187 eyes)that underwent cataract surgery at our hospital from July 2023 to July 2024 were enrolled. CEC were measured using a non-contact specular microscope. ND was measured through IOLMaster 700. A total of 187 participants were further stratified based on glycosylated hemoglobin(HbA1c)and fasting blood glucose(FBG)levels. Correlation analyses and multiple linear regression analyses were used to elucidate the association between diabetic status and ocular parameters. We measured the concentrations of ascorbic acid(AA)in the aqueous humor of 52 participants.

RESULTS: Compared to the control group, the diabetic group exhibited larger maximum endothelial cell size, lower endothelial cell density(ECD), a reduced proportion of hexagonal cells, higher ND, and lower corneal vertex equivalent spherical power(Scv; P<0.05). Correlation analysis revealed those changes of CEC and ND were significantly associated with the level of FBG, HbA1c, and the duration of diabetes(P<0.05). Among 52 participants, diabetic patients had lower levels of AA in their aqueous humor, indicating a diminished antioxidant ability.

CONCLUSION:Diabetic state can significantly influence corneal maximum cell size, hexagonal cell ratio and ND in cataract patients, potentially linked to a decrease in total antioxidant capacity of the aqueous humor.