Background/Objectives: To analyze corneal endothelial changes and intraocular pressure (IOP) after phacoemulsification combined with the eight-chop technique and intraoperative parameters in patients with diabetes mellitus. Methods: The eyes of patients with cataracts who underwent phacoemulsification were analyzed in this study. Based on their hemoglobin A1c levels, patients were divided into two groups. The eight-chop technique was used for cataract surgery. The operative time, the phaco time, the aspiration time, the cumulative energy dissipated, and the volume of fluid used were determined. 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 recorded before and after surgery. Results: Overall, 181 eyes of 138 patients with cataracts were evaluated. In the diabetes group, the CECD loss rates were 5.1%, 3.9%, and 2.1% at 7 weeks, 19 weeks, and 1 year postoperatively, respectively. In the control group, the CECD loss rates were 2.8%, 2.6%, and 1.2% at 7 weeks, 19 weeks, and 1 year postoperatively, respectively. Significant differences in the percentage decrease in CECD were observed between the two groups at 7 and 19 weeks postoperatively. 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). Significant differences were also observed between CV and PHC preoperatively, at 19 weeks, and 1 year postoperatively in the diabetes and control groups (p < 0.01). At 1 year postoperatively, IOP reduction rates were 8.0% and 11.2% in the diabetes and control groups, respectively. Conclusions: CECD loss was minimal with the eight-chop technique; however, the diabetes group showed a higher percentage decrease than the control group up to 19 weeks postoperatively. In addition, although IOP decreased in both groups after surgery, the percentage decrease was significantly different at 1 year postoperatively. This study suggests that the corneal endothelial cells of diabetic eyes may be more fragile than those of normal eyes and that the long-term postoperative IOP-lowering effect may be attenuated. These findings will contribute to advances in personalized treatment strategies for patients with diabetes.

Keywords: cataract surgery; corneal endothelial cell; diabetes mellitus; eight-chop technique; phacoemulsification.

背景/目的： 分析糖尿病患者在实施超声乳化白内障手术结合八步切核技术后的角膜内皮变化和眼压（IOP）以及术中参数。方法： 在本研究中分析了接受超声乳化白内障手术患者的患眼。根据其糖化血红蛋白A1c水平，患者被分为两组。使用八步切核技术进行白内障手术。确定了手术时间、超声乳化时间和吸引时间、累积能量消耗和使用的液体量。记录术前和术后最佳矫正视力（BCVA）、IOP、角膜内皮细胞密度（CECD）、中央角膜厚度（CCT）、变异系数（CV）和六边形细胞百分比（PHC）。结果： 总共评估了138名白内障患者的181只眼睛。在糖尿病组中，术后7周、19周和一年的CECD损失率分别为5.1%、3.9% 和2.1%。对照组中，术后的7周、19周和一年的CECD损失率分别 为2.8%、2.6% 和1.2%。在术后7周和19周，两组CECD减少百分比差异显著（p 结论： 使用八步切核技术时CECD损失最小；然而，在术后19周内，糖尿病组的百分比减少高于对照组。此外，尽管两组在手术后眼压均有所降低，但在一年后的百分比下降差异显著。本研究表明糖尿病患者眼睛中的角膜内皮细胞可能比正常眼睛中的更脆弱，并且长期的术后降眼压效果可能会减弱。这些发现将有助于推进糖尿病患者的个性化治疗策略。

关键词： 白内障手术；角膜内皮细胞；糖尿病；八步切核技术；超声乳化。