Endothelial damage with phacoemulsification and intraocular lens implantation

Specular microscopy was used to study the corneal endothelium in a series of patients undergoing phacoemulsification with and without intraocular lens implantation by one experienced surgeon. Cell loss after phacoemulsification alone was variable, but the mean was 18%, with a median of 11%. The patients undergoing phacoemulsification plus lens implantation showed a mean cell loss of 26%, with a median of 17%. This is considerably lower than has been reported with standard intracapsular extraction plus lens implantation. The decreased endothelial damage is attributed to the technique of inserting the lens through a small incision and maintaining an air bubble between the lens and the cornea throughout lens insertion and wound closure.