Relationship Between Postoperative Oxidative Stress Levels and Corneal Endothelial Cell Loss After Phacoemulsification in Diabetic Patients with Cataract

Objective: To investigate the relationship between postoperative oxidative stress and corneal endothelial cell loss in diabetic patients with cataract.

Methods: One hundred and twenty patients who underwent phacoemulsification were selected, including 80 diabetic patients with cataract and 40 patients with ordinary cataracts. Corneal endothelial cell loss was recorded, and the endothelial cell density (ECD), the proportion of hexagonal cells, and the corneal thickness within the central corneal area were compared. According to the severity of endothelial cell loss, the diabetic patients with cataract were divided into a general loss group (n = 37) and a serious loss group (n = 43), and the postoperative serum superoxide dismutase (SOD), malonaldehyde (MDA), and glutathione peroxidase (GSH-Px) were measured. The relationship between oxidative stress factors and corneal endothelial cell loss in diabetic patients with cataract was analyzed, and the predictive value of MDA, SOD, and GSH-Px was investigated by using receiver operating characteristic (ROC) curve.

Results: Diabetic patients with cataract had higher serum MDA and lower SOD and GSH-px, and higher fasting blood glucose concentration, glycosylated hemoglobin level, and low-density lipoprotein cholesterol (P < 0.05). The mean change in ECD in diabetic patients with cataract was 10.95%, which was greater than the 6.11% in non-diabetic patients with cataract (P < 0.05), and the proportion of hexagonal cells decreased and corneal thickness increased. MDA levels was negatively correlated with corneal endothelial cell loss in diabetic patients with cataract (r_s = 0.509), and SOD and GSH-px were negatively correlated (r_s = -0.361, r_s = -0.482). The area under the ROC curve of MDA, SOD, and GSH-px in corneal endothelial cell loss was 0.719, 0.773, and 0.752, respectively.

Conclusion: The degree of postoperative corneal endothelial cell loss in diabetic patients with cataract was greater and positively correlated with MDA, and negatively correlated with SOD and GSH-px.