AIM:To compare the effects of manual small incision cataract surgery and phacoemulsification combined with intraocular lens implantation on corneal endothelial cells in diabetic patients with age-related cataract.

METHODS: Totally 128 eyes of 128 diabetic patients with age-related cataract treated in our hospital from July 2015 to December 2017 were divided into manual small incision group and ultrasound group according to different surgical methods. The visual acuity, astigmatism, morphology and function of corneal endothelial cells were observed before and 1 and 6wk after operation.

RESULTS: The preoperative LogMAR visual acuity of manual small-incision group and ultrasound group were 0.75±0.30 and 0.80±0.29, which decreased to 0.14±0.05 and 0.15±0.04 at 6wk after surgery(P<0.05). The astigmatism were 0.87±0.28D and 0.84±0.27D before surgery, which increased to 1.64±0.52D and 1.52±0.42D at 1wk after surgery, and 1.33±0.44D and 1.23±0.38D at 6wk after surgery. The preoperative corneal thickness of manual small-incision group and ultrasound group were 529.15±42.51μm and 528.17±39.64μm, respectively, increasing to 548.14±36.54μm and 544.56±40.14μm at 1wk after surgery, decreasing to 531.01±42.15μm and 529.64±44.12μm at 6wk after surgery. The postoperative endothelial cell density were 2948.14±335.45/mm², 2894.17±365.21/mm², decreasing to 2714.15±431.01/mm², 2689.22±333.45/mm² at 6wk after surgery. The proportions of hexagonal cells were 52.16±10.11% and 49.51±11.07% before surgery, decreasing to 37.48±11.24% and 39.31±10.47% at 6wk after surgery. The preoperative corneal variation coefficients were 38.45±5.64 and 40.17±5.69, increasing to 43.27±4.85 and 44.01±4.91. There were significant differences in corneal thickness, endothelial cell density, hexagonal cell ratio and corneal variation coefficient at differences time points in the same groups(P<0.05).There was no significant difference between the two groups(P>0.05).

CONCLUSION: Manual small incision cataract and phacoemulsification combined with intraocular lens implantation can improve the visual acuity of diabetes mellitus patients with age-related cataract. There is no significant difference in visual acuity recovery and corneal endothelial cell injury after operation. The efficacy and safety are comparable.