Corneal thickness and endothelial damage after intraocular lens implantation

The corneal thickness and the specular appearance of the corneal endothelium are reported in 100 patients with unilateral intraocular lens implantation. Post-operative time ranged from one to 42 months. An average central endothelial cell loss of uncomplicated cases of 46%, range 1 to 83%, with no correlation with time after the operation was found. A significantly higher cell loss was found in cases with technical complications, shallow anterior chamber or increased intraocular pressure post-operatively. No correlation was found between the corneal thickness and the endothelial cell loss. In two patients, however, with a cell density below 500 cells/mm2, a slight increase in corneal thickness was noted. Thirty patients presented a guttate endothelium. Irrespective of the occurrence of surgical complications the presence of a guttate endothelium was found to be a major determinant of the corneal thickness increase and could be ascribed as a cause of persistent corneal swelling in six of twelve patients with elevated corneal thickness. The progression of guttate changes occurred independently of the cell loss.