ObjectiveTo investigate the relationship between aqueous humor cytokines and the changes of corneal endothelial cell density (ECD) after femtosecond laser-assisted cataract surgery (FLACS).MethodsThirty cataract patients who underwent FLACS at our ophthalmic clinic between February 2017 and July 2020 were enrolled. Preoperative aqueous humor cytokine concentrations were analyzed using a magnetic bead-based multiplex immunoassay system. ECD was measured using a corneal endothelial cell microscope before surgery and at 1, 6, and 12 months postoperatively.ResultsBCVA improved gradually after cataract surgery, and there were significant differences between preoperative visual acuity and postoperative visual acuity at 1, 6 and 12 months (all P<0.05). ECD decreased gradually after operation (P<0.05), with an average decrease at 1 to 6 months (1M-6M), 1 to 12 months (1M-12M) and 6 to 12 months (6M-12M). There were no significant differences in baseline aqueous humor cytokine levels, preoperative ECD, and changes of ECD at 1, 6, and 12 months after surgery between diabetic group and non-diabetic group (P>0.05). Pearson and Spearman correlation coefficient analysis showed that interleukin (IL)-7, interferon-induced protein-10 (IP-10), macrophage inflammatory protein (MIP)-1a, MIP-1B in aqueous humor were positively correlated with ECD loss from 1M to 6M (EDC1M-6M absolute value) (P<0.05). IL-1b, IL-7, IP-10, and regulated upon activation normal T cell expressed and secreted (RANTES) in aqueous humor were positively correlated with ECD loss at 1M-12M (EDC_1M-12M absolute value) (P<0.05), and IP-10, RANTES in aqueous humor were positively correlated with ECD loss at 6M-12M (EDC_1M-12M absolute value) (P<0.05). Multivariable stepwise regression analysis showed that IL-7 in aqueous humor was a strong influencing factor of ECD loss at 1M-6M, while IP-10 was a strong influencing factor of ECD loss at 1M-12M (P<0.05).ConclusionIL-7 and inflammatory cytokines in aqueous humor were positively correlated with ECD loss after FLACS, suggesting that these cytokines may promote the progression of ECD injury.