ArticleClinical ophthalmology (Auckland, N.Z.)2026
Cigarette Smoking as an Independent Predictor of Endothelial Cell Loss After Cataract Surgery: A Prospective Cohort Study.
Article in Clinical ophthalmology (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Purpose: To assess the impact of cigarette smoking on corneal endothelial cell density (ECD), central corneal thickness (CCT), and endothelial morphology following cataract surgery in older adults, and to determine whether smoking independently predicts postoperative endothelial cell loss. Methods: Prospective, observational cohort study conducted at the Institute of Ophthalmology, University of Modena and Reggio Emilia. Patients over 40 years of age undergoing cataract surgery were enrolled and classified as smokers or non-smokers. ECD, CCT, polymegathism, and pleomorphism were assessed preoperatively and at 1 and 3 months postoperatively using specular microscopy. Smoking exposure was quantified in Pack-Years. Statistical analyses included Student's t-tests, multivariate linear regression, and Cohen's d for effect size estimation. Results: A total of 80 eyes from 80 patients were analyzed. Smokers had significantly lower baseline ECD (2294.8 vs 2523.9 cells/mm Conclusion: Cigarette smoking is associated with accelerated endothelial cell loss and impaired corneal recovery after cataract surgery. Smoking history should be systematically incorporated into preoperative risk assessments and patient counseling, with consideration for enhanced perioperative monitoring in smokers.
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