[Protective effect of the anterior lens capsule: corneal endothelial cell loss following intercapsular...

In an experimental study using rabbits, the intercapsular technique was performed in 20 eyes to make a small anterior capsulotomy. A large, "can opener" capsulotomy was performed in 20 eyes, and ten eyes (five non-operated animals) served as controls. Endothelial cell loss was determined by vital staining with Trypan blue and Alizarin red S. Average endothelial cell loss with the intercapsular technique was 1.2%; with the can opener technique the cell loss was 6.6%. This difference was statistically significant (p less than 0.01). The percentage in the control eyes was 0.05%. Positive relations between endothelial cell loss related to phacoemulsification time and/or the amount of irrigating fluid used existed for the can opener group only (p less than 0.01). These results demonstrate that the presence of an almost intact anterior lens capsule during removal of lens substance is protective to the corneal endothelium.