Subcapsular phacoemulsification and aspiration

To protect the corneal endothelium from ultrasound damage, we performed phacoemulsification under the anterior capsule on 26 eyes of 21 patients between January 7, 1980, and September 1, 1980. Patients were followed for at least three years. In 20 eyes, various intraocular lenses were implanted. The average corneal endothelial cell loss in all eyes was 12.0 +/- 7.4% (M.S.D.), range 1.3% to 36.2%. In six eyes without intraocular lens implantation, the average cell loss was 6.9 +/- 3.0% (M.S.D.), range 1.3% to 10.0%. The best postoperative visual acuity was 20/40 or better in all patients. Intraoperative and postoperative complications occurred in 11 eyes (42.3%), including three (11.5%) posterior capsule ruptures. All complications were managed satisfactorily.