Response of the corneal endothelium to cataract surgery
R. O. Schultz, D. B. Glasser, M. Matsuda, R. W. Yee and H. F. Edelhauser
Regional changes in endothelial cell density, morphology, and corneal
thickness were serially examined with a specular microscope after
intracapsular cataract extraction (four eyes), extracapsular cataract
extraction (five eyes), and extracapsular cataract extraction with
posterior chamber lens implantation (13 eyes). Regardless of the type of
cataract surgery, cell loss and morphologic changes (decreased percentage
of hexagonal cells, increased cellular elongation, and increased
coefficient of variation) were greatest and occurred within one week in the
superior cornea. Similar changes occurred after one month centrally but
were minimal inferiorly. Endothelial cell density stabilized, and the
morphologic changes resolved within three months in all regions of the
cornea. Corneal swelling resolved within one month. Differences between the
procedures were noted only in the superior portion of endothelium, where
cell loss and morphologic changes were greatest following intracapsular
cataract extraction. Also, endothelial wound healing was complete and
stable three months after cataract surgery, with or without posterior
chamber lens implantation.
