The effect of vitreous and retinal surgery on corneal endothelial cell density

The effect of vitreoretinal surgery on corneal endothelial cell density was studied prospectively in 69 eyes by comparing preoperative endothelial cell densities to postoperative data. The mean cell loss in eyes of diabetic patients did not differ significantly from those of non-diabetics. The mean endothelial cell loss in 30 phakic eyes which underwent pars plana vitrectomy without lens removal was 1.3 +/- 1.4%. In aphakic eyes, vitrectomy and scleral buckling led to a mean cell loss of 12.6 +/- 2.3%. When vitrectomy was combined with lentectomy and scleral buckling, the mean cell loss was 8.5 +/- 1.8%, but eyes undergoing fluid-gas exchange in addition to these procedures suffered a mean cell loss of 16.9 +/- 1.9%. The presence of the lens protects the corneal endothelium during pars plana vitrectomy, while fluid-gas exchange in aphakic eyes appears to have a detrimental effect.