[Phakoemulsification using the Girard apparatus. Experimental study of the effects on the corneal endothelium of the...

The purpose of this paper was to investigate the potential alterations of the corneal endothelium following phacofragmentation with the Girard Ultrasonic Phacofragmentation Unit. The study was done in rabbit corneas using the specular microscope, nitroblue tetrazoium staining, and scanning electron microscopy. The perfusion fluid was Plasmalyte 148 R (Travenol), a solution which has been previously evaluated in this type of operation. Two experiments were done: (1) The effects of ultra-sound and irrigation for a period of three minutes, and (2) The effect of phacofragmentation for an average time of ten minutes. Results of the first experiment showed no cell destruction, but increased permeability to nitroblue tetrazolium. The second study showed areas of isolated or confluent cell destruction probably caused by mechanical trauma due to instrumentation or by lens nucleus rubbing against the corneal endothelium. These lesions have been observed with other instruments in similar techniques of lens removal.