Corneal complications of cataract surgery

Developments in cataract surgery have stimulated a greater interest in minimizing unwanted effects of cataract surgery on the cornea. The two main areas of concern are protection of the corneal endothelium and minimizing distortion of the anterior corneal surface. Endothelial cell loss is of particular importance where there is a preexisting significantly low cell count due to ocular trauma, surgery, or dystrophy, and in situations where cataract extraction is combined with other procedures that may be prolonged or require extensive manipulation. Recent availability of heavier molecular-weight viscoelastic substances are expected to help in minimizing endothelial cell trauma in these situations. In terms of postoperative corneal astigmatism the emphasis has changed for those who are regularly performing phacoemulsification from minimizing surgically induced astigmatism to planning the procedure so that it incorporates a correction of preexisting astigmatism. This emphasis may be more significant in cases of previous anterior segment surgery or trauma.