Corneal Endothelial Cell Changes After Femtosecond Laser–Assisted Cataract Surgery in Diabetic and Nondiabetic Patients

Objective: To compare corneal endothelial cell changes after femtosecond laser–assisted cataract surgery (FLACS) in diabetic and nondiabetic patients. Methods: This retrospective study included patients with cataract who underwent FLACS performed by a single surgeon between August 2018 and November 2020. Changes in corneal endothelial cell density (ECD), hexagonality, coefficient of variation in cell size (CV), and central corneal thickness (CCT) at baseline and at the 1-month and 3-month postoperative follow-ups were investigated by dividing the patients into diabetic and nondiabetic groups. Results: We included 75 patients (60% men, mean age: 57.7±11.4 years, range: 27–80 years) in the analysis: 31 diabetic patients (64% men, mean age: 58.7±11.9 years, range: 27–79 years) and 44 nondiabetic patients (56% men, mean age: 57.1±11.3 years, range: 34–80 years). No differences were observed between the two groups as regards preoperative and intraoperative parameters, the mean postoperative ECD, hexagonality, and CV. At 1 month postoperatively, the CCT was significantly greater in the diabetic group ( P =0.034); however, at 3 months, there was no significant difference between the two groups ( P =0.927). Conclusions: Changes in postoperative corneal endothelial cells were comparable between patients with and without diabetes after FLACS. Femtosecond laser–assisted cataract surgery seems to cause less damage to the corneal endothelium in diabetic patients because it uses less phacoemulsification energy.