AIM:To investigate the changes of corneal endothelial cells and tear film in diabetic cataract patients after operation.

METHODS: Totally 88 patients(88 eyes)with diabetic cataract(study group)treated in our hospital from June 2016 to June 2017 were retrospectively analyzed, and 100 patients(100 eyes)with senile cataract(control group)were selected. Patients of two groups underwent phacoemulsification and foldable intraocular lens implantation and followed up for 3mo. The corneal endothelial cell density, endothelial cell coefficient of variation and hexagonal cell proportion were measured by TOPCON SP - 3000P non-contact corneal endothelial tester before and after operation in two groups. The tear break-up time(BUT), basal tear secretion test(SⅠt)and corneal fluorescein test(FL)in two groups were observed.

RESULTS: There was no difference in corneal endothelial cell density between the two groups before treatment and 7d after treatment(P>0.05). The corneal endothelial cell density in the study group was significantly lower than that in the control group(3mo after treatment)(P<0.05). The density of corneal endothelial cells decreased significantly in two groups at each time points after treatment(P<0.05). The variation coefficient of corneal endothelial cells showed significant difference between groups at 7d and 3mo after treatment(P<0.05). The variation coefficient levels of corneal endothelial cells in both groups increased after treatment(P<0.05). The ratio of hexagonal cells decreased after treatment(P<0.05), and the ratio of hexagonal cells at 7d and 3mo after treatment in study group was significantly lower than that of the control group(P<0.05). Before treatment, there was no difference in BUT, SⅠt and FL between the two groups(P>0.05). BUT and FL between the two groups at 7d after treatment had no significant difference(P>0.05), while the SⅠt of the study group was significantly lower than that of the control group(P<0.05). BUT and SⅠt of the study group were significantly lower than those of the control group at 3mo after treatment(P<0.05), with no difference in FL between the two groups(P>0.05). After treatment, BUT, SⅠt and FL were improved in the two groups(P<0.05).

CONCLUSION: Phacoemulsification has some damage to corneal endothelial cells and destroys the stability of tear film, corneal endothelial cells are damaged more severely and recover slowly after operation especially in diabetic cataract patients.