Abstract：【Objective】To investigate the effect of diabetic retinopathy (DR) and glycosylated hemoglobin A1c (HbA1c) on corneal endothelium in diabetic patients.【Methods】A total of 167 patients (334 eyes) with cataract diagnosed and treated in the Ophthalmology Department of Yuhuangding Hospital from February 2023 to June were selected in the study. Among them, 117 patients with diabetes (234 eyes) were included in the observation group, and 50 patients without diabetes (100 eyes) were included in the control group. According to the clinical stage of DR, the observation group was divided into no DR group (NDR group), non-proliferative diabetic retinopathy group (NPDR group) and proliferative diabetic retinopathy group (PDR group). According to the HbA1c results after admission, the patients were further divided into group A (HbA1c < 7.5%), group B (7.5%≤HbA1c < 8.5%), group C (8.5%≤HbA1c < 9.5%) and group D (HbA1c≥9.5%). Endothelial cell microscopy was used to detect the corneal endothelial density (ECD), cell area standard deviation (SD), and variation coefficient(CV), hexagonal cell percentage (HCR) and central corneal thickness (CCT) in all patients for comparison.【Results】Compared with the control group, the ECD of the observation group decreased, while SD and CV increased; And the difference was statistically significant (P<0.05) There was no statistically significant differences in HCR and CCT between the two groups (P>0.05). Compared with the NDR group and the NPDR group, ECD in the PDR group was significantly reduced, and the differences were statistically significant (P<0.05), however, there was no statistically significant difference between ECD in the NDR group and the NPDR group (P>0.05). There were statistically significant differences in CV of the NPDR group and the PDR group (P<0.05), if compared to the NDR group; But there were no statistically significant differences in SD of the NPDR group and the PDR group with the NDR group (P>0.05). There were no statistically significant differences in SD and CV between the NPDR group and the PDR group (P>0.05). There were no significant differences in HCR and CCT among the NPDR group, the PDR group and the NDR group (P>0.05). With the increase of HbA1c level, ECD in groups A, B, C and D decreased in order, and there were statistically significant differences in ECD and SD in groups B, C and D compared with group A (P<0.05), though there were no statistically significant differences in ECD and SD among groups B, C and D (P>0.05). There was statistical significance in CV between group A and group C (P<0.05), but there was no statistical significance in CV of group A comparing with group B and D (P>0.05). There were no significant differences in HCR and CCT among group A, group B, group C and group D (P>0.05). Age was negatively correlated with CCT (P<0.05). The duration of diabetes was negatively correlated with ECD (P<0.05), and positively correlated with SD and CV (P<0.05). The level of HbA1c and the severity of DR Were negatively correlated with ECD (P<0.05).【Conclusion】The increase of the degree of DR lesions and the increase of HbA1c level can lead to the decrease of ECD and the increase of CV. The number and morphology of corneal endothelial cells will change with the prolonged course of diabetes and unstable blood glucose control, which can lead to a decline in corneal endothelial cell function.
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2024, Vol. 41 
