Corneal Endothelial Changes after Phacoemulsification using the Eight-chop Technique in Patients with Diabetes

Objectives: To investigate corneal endothelial changes and intraocular pressure (IOP) after phacoemulsification using the eight-chop technique and intraoperative parameters in patients with diabetes. Methods: This study included the eyes of patients with cataracts who had undergone phacoemulsification. Cataract surgery was performed using the eight-chop technique. The operative time, phaco time, aspiration time, cumulative dissipated energy, and volume of fluid used were measured. The best-corrected visual acuity, IOP, corneal endothelial cell density (CECD), central corneal thickness (CCT), coefficient of variation (CV), and percentage of hexagonal cells (PHC) were measured pre- and post-operatively. Results: Overall, 181 eyes of 138 patients with cataracts were evaluated. The diabetes group showed CECD loss rates of 5.1%, 3.9%, and 2.1% at 7 weeks, 19 weeks, and 1 year postoperatively, respectively. The control group showed CECD loss rates of 2.8%, 2.6%, and 1.2% at 7 weeks, 19 weeks, and 1 year postoperatively, respectively. Significant differences in the CV and PHC were observed preoperatively and postoperatively between the diabetes and control groups (p < 0.01 or p = 0.01, 0.02). Furthermore, significant differences were observed between the CV and PHC preoperatively and that at 19 weeks and 1 year postoperatively in the diabetes and control groups (p < 0.01). The IOP reduction rates were 8.0% and 11.2% in the diabetes and control groups, respectively, at 1 year postoperatively. Conclusions: CECD loss in the eight-chop technique was minimal. The repair and healing mechanisms of the endothelium may have increased by phacoemulsification using the eight-chop technique postoperatively. The IOP reduction was maintained in both groups postoperatively.