AKR1B1 and diabetes mellitus: The possible explanation for corneal endothelial changes in DM patients is multifactorial including impairment of apical junctions on the endothelial cells, impairment of physical barriers of corneal cell and altered permeability of corneal cell due to reduced Na + /K + ATPase activity pump in the endothelial cells [19, 20] Diabetic cornea especially with high glucose can lead cellular swelling due to increased sorbitol inside the cells due to increased activity of aldose reductase [19, 21].