The Effect of Hispanic Ethnicity on Corneal Endothelial Cell Loss in Cataract Surgery

Abstract

Purpose : Cataract surgery is known to cause a corneal endothelial cell loss (ECL) of 5-20%. As there are differences in anterior segment anatomy among different ethnicities, such ECL may also differ. However, there are limited data on ethnical differences in ECL. Thus, this study aimed to compare ECL in cataract surgery between Hispanics and non-Hispanics.

Methods : This retrospective study included 227 patients aged 50 years or older who underwent phacoemulsification and intraocular lens implantation for senile cataract in San Antonio, TX. We included patients with White race who identified as Hispanic or non-Hispanic. Patients with prior corneal or anterior segment surgery, ocular trauma, or non-White race were excluded. In addition to preoperative IOL-Master measurements, specular microscopy was performed before and at 1-2 months after surgery. Regression analysis was used to compare ECL between Hispanics and non-Hispanics considering confounding factors such as age, sex, axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and phaco cumulative dissipative energy (CDE). For analysis, we used average values of both eyes when available.

Results : There were 227 patients, including 109 Hispanics and 118 non-Hispanics, with an average age of 70.3±8.1 years. Before surgery, Hispanics had a significantly lower ACD compared to non-Hispanics (3.12±0.36 vs 3.25±0.37 mm, respectively, P=0.009). There were no significant differences between Hispanics and non-Hispanics regarding AL (P=0.10), LT (P=0.30), and CDE (P=0.79). Preoperative corneal endothelial cell density was 2547±365 cells/mm² in Hispanics and 2483±380 cells/mm² in non-Hispanics (P=0.26). After surgery, the cell density was 2127±550 and 2053±563 cells/mm², respectively (P=0.32). There were no significant differences between Hispanics and non-Hispanics in ECL (16.8±17.0 vs 17.4±18.1%, P=0.85), increase in the coefficient of variation (3.8±20.7 vs 1.5±21.6%, P=0.61), or decrease in the hexagonal cell percentage (3.7±13.0 vs 2.4±10.4%, P=0.08). The only parameters significantly associated with ECL in cataract surgery were lower ACD (P= 0.003) and higher CDE (P<0.001).

Conclusions : There are no significant differences in corneal ECL during cataract surgery between Hispanics and non-Hispanics.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.