Racial Differences in Corneal Endothelial Cells in Adult Patients

To assess the racial differences in corneal endothelial cell parameters in adult patients undergoing cataract surgery.

This retrospective study included 218 eyes of 218 patients 50 years or older who underwent surgery for senile cataract. Patients with cornea/anterior segment abnormalities, trauma, or surgery were excluded. Preoperatively, all patients had specular microscopy to evaluate endothelial cell density (ECD), hexagonal cell percentage (HEX%), coefficient of variation (CV), and pachymetry. Corneal endothelial cell and ocular biometric parameters were then compared between White and Black participants. Correlations between endothelial cell parameters and ocular biometric parameters from IOLMaster were also examined.

There were 154 White and 64 Black individuals. There were no significant differences between the races in age, sex, anterior chamber depth, axial length, or steep keratometry. However, Black patients had significantly lower pachymetry (544.22 ± 35.49 vs. 558.59 ± 38.39 µm, P = 0.01), lower lens thickness (4.28 ± 0.51 vs. 4.50 ± 0.51 mm, P = 0.004), and greater flat keratometry (43.61 ± 1.42 vs. 43.01 ± 1.86 degrees, P = 0.02) compared with White patients. For corneal endothelial parameters, HEX% was significantly lower in Black patients (56.4 ± 5.8%) than in White patients (58.7 ± 5.9%, P = 0.01). However, no significant differences were noted in ECD (P = 0.75) or CV (P = 0.22) between White and Black patients. ECD had a significant positive correlation with pachymetry, whereas CV had a significant negative correlation with axial length.

In addition to some anatomical differences in anterior segment anatomy, HEX% was significantly lower in Black patients than in White patients.