Specular microscopy in cataract and intraocular lens patients. A report of 564 cases

We studied 564 patients who underwent cataract surgery, using preoperative and postoperative endothelial cell photographs and corneal thickness measurements. No statistically significant difference was noted in endothelial cell loss between patients with intracapsular cataract extraction (12.6%) and those undergoing posterior chamber phacoemulsification (15.2%). Both procedures had significantly less cell loss than with anterior chamber phacoemulsification (27.3%). Intraocular lens implantation produced a mean endothelial cell loss of 15.8% to 20.9%, depending on surgical technique and implant type. A Choyce-style lens resulted in statistically less cell loss than with other implants. Mean endothelial cell loss was 17.8% with clinically atraumatic and 27.3% with clinically traumatic implantations. Corneal thickness measurements did not correlate with endothelial cell loss or trauma observed clinically at the time of surgery and did not seem helpful in the preoperative evaluation of cataract cases.