To compare the morphologic features of corneal endothelium in patients with cataract and clear lenses.

A single, observational clinic-based case-control study.

In this single, observational clinic-based case-control study at Iladevi Cataract & IOL Research Centre, Ahmedabad, India, 2,025 eyes of 2,025 individuals with cataract and clear lenses were evaluated for corneal endothelial morphologic features, which included the endothelial cell density (ECD), coefficient of variation (CV) of cell area, and percentage of hexagonal cells. Nine hundred and thirty-nine eyes of patients with clear lenses were assigned to the control group and 1,086 eyes of patients with cataract were assigned to the case group. The main outcome measures studied were the influence of variables such as age, gender, axial length, and anterior chamber depth on the corneal endothelial morphologic features in patients with cataract and clear lenses.

Eyes in the cataract group had a low mean ECD (2241.52 ± 158.69 cells/mm² vs 2446.04 ± 197.79 cells/mm²), high CV of cell area, and low mean percentage of hexagonal cells compared with those in the clear lens group. Multiple linear regression analysis revealed a reduction in ECD in the presence of cataract, in female subjects, and with advancing age, whereas an increase in ECD was noted with an increase in anterior chamber depth of more than 2.7 mm (P = .020) and an increase in axial length of more than 24.0 mm (P < .001).

Patients with cataract had lower levels of ECD than the corresponding normal population. In multiple regression analysis, after taking into account all the variables, we found a significant impact on the morphologic features of corneal endothelium in patients with cataract when compared with those with clear lenses.