Corneal endothelial cell loss in phacoemulsification surgery with silicone intraocular lens implantation

Abstract

To clarify the extent of corneal endothelial injury from silicone intraocular lens (IOL) implantation in small incision cataract surgery. Two hundred forty eyes that had phacoemulsification surgery were divided into four groups: Group A comprised 70 eyes that received a conventional silicone IOL; Group B, 63 eyes that received a higher refractive index silicone IOL; Group C, 71 eyes that received a poly(methyl methacrylate) (PMMA) IOL; Group D, 36 eyes that had phacoemulsification without an IOL. Cell density of the corneal endothelium in all eyes was examined by specular microscopy preoperatively and 3 months postoperatively, and the percentage of endothelial cell loss was determined. The differences in endothelial cell loss between the four groups were statistically compared using the Kruskal-Wallis test. Percentages of endothelial cell loss were 4.5 +/- 5.1% in Group A, 4.3 +/- 5.3% in Group B, 6.3 +/- 5.4% in Group C, and 4.3 +/- 4.9% in Group D. No statistically significant difference was observed among these four groups, although the percentage of cell loss in Group C was slightly larger than that in the other groups. The implantation of silicone IOLs and PMMA IOLs causes minimal corneal endothelial cell loss in contemporary small incision surgery.