Endothelial cell loss in four types of intraocular lens implant procedures

Corneal endothelial cell loss is compared in four types of cataract procedures with intraocular lens implants performed by the authors. A total of 110 intracapsular cataract extractions, 182 extracapsular cataract extractions and 107 phacoemulsifications, divided into 47 anterior chamber emulsifications and 60 posterior chamber emulsifications (all with intraocular lens implants) are compared. A significant feature of these procedures is the incidence of endothelial cell loss greater than 1,200 cells/mm2. This occurred in 1% of the intracapsular cataract extractions, 4% of the planned extracapsular cataract extractions, 13% of the posterior chamber phacoemulsifications, and 17% of the anterior chamber phacoemulsifications. Pachymetry is a poor method for judging operative corneal endothelial trauma. Based upon the results of this study, it remains to be seen whether the advantages of phacoemulsification mitigate against the increased incidence of significant endothelial cell loss.