目的：探讨伴有糖尿病的年龄相关性白内障(ARC)患者超声乳化术后角膜内皮细胞及眼表的变化。方法：回顾性病例研究。选取2017-01/2019-01我院收治的190例190眼接受超声乳化手术联合人工晶状体植入的伴有糖尿病的ARC患者(观察组)。另选取同期接受超声乳化手术联合人工晶状体植入的无糖尿病的ARC患者230例230眼作为对照组。比较两组患者手术前后眼表疾病指数(OSDI)评分，泪膜破裂时间(BUT)、基础泪液分泌试验(SⅠt)，角膜内皮细胞密度及变异系数指标。结果：两组患者术前OSDI评分、BUT、SⅠt、角膜内皮细胞密度及变异系数比较无差异(P>0.05)。观察组患者术后1wk，1、3mo，OSDI评分均较术前明显增加(均P<0.01)； 对照组患者术后1wk，1mo OSDI评分均较术前明显增加(均P<0.01)，术后各时间点OSDI评分观察组高于对照组(均P<0.05)。两组患者术后1wk，1mo BUT，SⅠt较术前明显下降(P<0.05)，术后3mo与术前相比无差异(P>0.05)。且两组之间BUT对比，观察组BUT更低，下降更显著(P<0.05)。两组患者角膜内皮细胞密度术后1wk，1、3mo较术前明显下降(P<0.05)，观察组与对照组角膜内皮细胞密度相比，观察组下降更显著(P<0.05)。两组角膜内皮细胞变异系数术后1wk，1mo较治疗前有差异(P<0.05)，术后3mo与术前相比无差异(P>0.05)。观察组角膜内皮细胞变异系数改变相比对照组更显著(P<0.05)。结论：伴有糖尿病的ARC患者手术耐受性低，其角膜内皮细胞密度、角膜泪膜稳定性与基础泪液分泌均与治疗前有显著变化，并且其特征较无糖尿病的ARC患者更加明显，临床应加强术中以及术后保护角膜内皮以及眼表面组织的保护能力。

AIM: To investigate the changes of corneal endothelial cells and ocular surface after phacoemulsification for age-related cataract(ARC)patients with diabetes mellitus. METHODS: Retrospective case study. A total of 190 cataract patients with diabetes mellitus who received phacoemulsification combined with IOL implantation in 190 eyes admitted to our hospital from January 2017 to January 2019 were selected. In addition, 230 ARC patients without diabetes who underwent phacoemulsification and intraocular lens implantation at the same time were selected as the control group. Ocular surface disease index(OSDI)score, tear film rupture time(BUT), basal tear secretion test(S I t), corneal endothelial cell density and coefficient of variation were compared between the two groups.RESULTS: There was no significant difference in preoperative OSDI score, BUT, S I t, corneal endothelial cell density and coefficient of variation between the two groups(P>0.05). In the observation group, OSDI scores were significantly increased 1wk, 1mo and 3mo after surgery compared with those before surgery, with statistically significant differences(all P<0.01). The OSDI scores of patients in the control group increased significantly one week and one month after the operation compared with those before the operation, with statistically significant differences(all P<0.01). The OSDI scores in the observation group at each time point after the operation were higher than those in the control group, with statistically significant differences(all P<0.05). One week after surgery, 1mo after surgery, BUT and S I t in the two groups decreased significantly compared with that before surgery(P<0.05), and the difference was not statistically significant compared with that before surgery 3mo after surgery. In addition, compared with BUT between the two groups, the observation group had a lower tear film stabilization time and a more significant decrease(P<0.05). The corneal endothelial cell density in the two groups decreased significantly 1wk, 1mo and 3mo after surgery compared with that before surgery(P<0.05). The variation coefficient of corneal endothelial cells in the two groups was statistically significant 1wk after the operation and 1mo after the operation compared with that before the treatment(P<0.05). The variation coefficient of corneal endothelial cells in the observation group was more significant than that in the control group(P<0.05).CONCLUSION: Cataract patients with diabetes surgery tolerance is low, the corneal endothelial cell density and the central corneal thickness and corneal appears before tear secretion with stability and foundation treatment have significant changes, and its characteristic is cataract patients without diabetes more apparent, clinical intraoperative and postoperative corneal endothelial protection should be strengthened, and the surface of the eye protection ability of the organization.