To analyze the influence of preoperative corneal endothelial status on postoperative corneal endothelium density after cataract surgery.

We evaluated 228 eyes of 158 patients who underwent cataract surgery. Corneal endothelial status and central corneal thickness were measured before surgery and 1 day, 1 month, 3 months and 6 months after surgery. Patients were classified by preoperative endothelial cell density (three groups) and their coefficients of variation and hexagonality (two groups). Clinical parameters, including corneal endothelial cell losses, visual acuity, intraocular pressure, spherical equivalent refraction and central corneal thickness were measured to compare the intergroup indices.

There were no significant differences in corneal endothelial cell losses at 1 day, 1 month, 3 months and 6 months after surgery in any of the groups based on corneal endothelial cell density. There were increases in corneal thickness at 1 day and 1 month after surgery that were significantly higher in the low-endothelial cell density group than the 2,000-2,500 cells/mm² cell density group ( p < 0.05), but there were no differences after the 3-month time point. There were no significant differences in clinical parameters for the coefficient of variation and hexagonality groups until 6 months after surgery.

We observed reversible corneal edema in the low endothelial group; however, there were no significant intergroup differences in corneal endothelial cell loss due to preoperative corneal endothelial status. Our results suggest that cataract surgery is relatively safe for patients with morphologically abnormal corneal endothelium and/or low endothelial density; the safety is primarily due to improved equipment and surgery techniques.