Specular microscopy of the corneal endothelium and lens implant surgery

Specular microscopy helps to estimate the viability of the corneal endothelium long before clinical signs of decompensation occur. Therefore, specular microscopy is useful for the selection of eyes for lens implantation in general; for the prognosis of the eye with a lens implant; and for the evaluation of the method of cataract surgery, of lens implantation techniques, and possibly of lens design, material, and manufacturing. A long-term study of intracapsular and extracapsular pseudophakic eyes revealed that the intracapsular pseudophakic eyes had significantly less endothelial cells, which could partly be explained by toxicity of the Supramid used as loop material, but mostly by assuming continuing endothelial disintegration in the intracapsular eyes. In 41 patients our extracapsular technique caused an average cell loss of only 6.7%.