AIM:To investigate the characteristics of corneal endothelial cells(CEC)and nuclear density(ND)in cataract patients with type 2 diabetes and to assess the impact of blood glucose related indicators.

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.