ORIGINAL RESEARCH article

Front. Ophthalmol.

Sec. Cornea and Refractive Surgery

Central corneal thickness, corneal endothelial cell density, and morphology in myopic eyes of young Chinese candidates for refractive surgery

  • 1. Department of Ophthalmology, Jiangnan University Medical Center, Wuxi, China

  • 2. Wuxi Aier Eye Hospital, Wuxi, China

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Abstract

Purpose: To assess central corneal thickness (CCT), as well as the density and morphology of corneal endothelial cells (ECD) in myopic eyes. Methods: A total of 400 patients scheduled for myopic refractive surgery were consecutively enrolled in this study. Preoperative evaluations encompassed endothelial cell density (ECD), average cell area (CA), coefficient of variation (CV), and percentage of hexagonality (HEX), all measured using the Nidek CEM-530. Additionally, central corneal thickness (CCT) was assessed using the Pentacam HR. Ocular biometric parameters, including axial length (AL), were recorded with the IOL Master 700. Each parameter was analyzed based on ocular laterality, age, gender, spherical equivalent (SE), and AL. Results: The analysis revealed that 39% of participants were female, with a mean age of 25.36±6.92 years and a mean SE of -5.06 ±1.92D. No statistically significant differences in ECD were observed between genders, although males showed slightly higher values for HEX and CCT. No significant differences in CCT, ECD, or corneal endothelial morphology were found among subgroups categorized by SE or AL. Significant negative correlations were observed between age and both ECD (r = -0.197, P < 0.001) and CCT (r = -0.111, P = 0.026), while positive correlations were noted with CA (r = 0.166, P = 0.001) and CV (r = 0.364, P < 0.001). After adjusting for age, ECD showed no significant association with SE or AL but demonstrated a weak positive correlation with CCT (r = 0.128, P = 0.011). Conclusions: SE and AL show no significant effect on CCT or corneal ECD and morphology in our refractive surgery candidates. Weak age-CCT/ECD correlations were noted. Gender and ocular laterality effects warrant preoperative evaluation.

Summary

Keywords

central corneal thickness, Corneal Endothelial Cell Density, corneal endothelial cell morphology, Myopia, young adults

Received

17 December 2025

Accepted

20 February 2026

Copyright

© 2026 Wu, Zhang, Wang, Gong, Guo and Ye. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Nan Ye

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