Corneal Endothelial Cell Loss in Shallow Anterior Chamber Eyes After Phacoemulsification Using the Eight-Chop Technique

Abstract

Objectives: In this study, the correlation between anterior chamber depth (ACD) and corneal endothelial cell density (CECD) loss was evaluated, and an assessment was made of the safety and efficacy of the eight-chop technique in cataract surgery for patients with shallow anterior chamber (SAC) depth. Methods: The technique was applied to patients with SAC and normal ACD, defined as <3 mm and ≥3 mm, respectively. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), CECD, coefficient of variation, percentage of hexagonal cells, and central corneal thickness were assessed pre- and postoperatively. Operative time, phaco time, aspiration time, cumulative dissipated energy (CDE), and volume of fluid used were recorded intraoperatively. Results: A total of 180 eyes from 99 patients (mean age, 74.8 ± 5.1 years; 28 men, 71 women) were analyzed. In the SAC group, the mean operative time, phaco time, aspiration time, CDE, and volume of fluid used were 4.7 min, 15.4 s, 65.6 s, 5.87, and 26.6 mL, respectively, demonstrating favorable surgical metrics. CECD loss was 1.3% at 7 weeks, 1.1% at 19 weeks, and 0.9% at 1 year, with no significant decrease after surgery in the SAC group. No correlation was observed between CECD loss and ACD in either group. Conclusions: These findings suggest that the eight-chop technique is a minimally invasive and effective approach that preserves corneal endothelial integrity, even in patients with SAC depth.

Keywords: cataract surgery; corneal endothelial cell; eight-chop technique; phacoemulsification; shallow anterior chamber.