Endothelial cell density changes in diabetic and nondiabetic eyes undergoing phacoemulsification employing phaco-chop technique.

Purpose: To assess endothelial cell density (ECD) changes on diabetic and nondiabetic patients after phacoemulsification surgery employing the phaco-chop technique.

Methods: This is a prospective, experimental and comparative study. We included type-two diabetic (T2DM) patients and nondiabetic patients who underwent phacoemulsification performed by a single surgeon employing the horizontal phaco-chop technique. ECD and central corneal thickness (CCT), the coefficient of variation and percentage of polymegathism were measured and compared. Specular microscopy was used to evaluate the number of endothelial cells in patients during surgical pre-assessment and at the 1- and 3-month follow-up visits.

Results: A total of 42 eyes from 42 patients were included: 21 eyes in the T2DM group and 21 eyes in the nondiabetic group. No statistically significant differences were found between groups in terms of age and sex distribution (p = 0.296; p = 0.502, respectively). Mean postoperative (at 1 and 3-month follow-up) endothelial cell count of the T2DM group was not significantly lower than the nondiabetic group (p = 0.341 and p = 0.065, respectively). Postoperative CCT measurements demonstrated no significant variations between groups, showing a mean 557.8 ± 48.0 and 543.3 ± 41.0 μm, respectively (p = 0.472). Nonetheless, significant differences were evidenced for CoV values for both the pre-surgical and the postoperative follow-up visits between groups, as well as ECD values inside each group.

Conclusions: The present study reveals significant differences between pre-surgical and postoperative mean ECD values; however, no statistically significant differences were found when comparing ECD at each follow-up visit between diabetic patients without evidence of high-risk proliferative diabetic retinopathy and nondiabetic patients undergoing phacoemulsification employing phaco-chop technique.