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Response of the Corneal Endothelium to Cataract Surgery

Response of the Corneal Endothelium to Cataract Surgery Abstract • 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. References 1. Hirst L, Snip R, Stark W, et al: Quantitative corneal endothelial evaluation in intraocular lens implantation and cataract surgery . Am J Ophthalmol 1977;84:775-780. 2. Galin M, Lin L, Fetherolf E, et al: Time analysis of corneal endothelial cell density after cataract extraction . Am J Ophthalmol 1979;88:93-96. 3. Rao G, Stevens R, Harris J, et al: Long-term changes in corneal endothelium following intraocular lens implantation . Ophthalmology 1981; 88:386-397.Crossref 4. Liesegang T, Bourne W, Ilstrup D: Shortand long-term endothelial cell loss associated with cataract extraction and intraocular lens implantation . Am J Ophthalmol 1984;97:32-39. 5. Inaba M, Matsuda M, Shiozak Y, et al: Regional specular microscopy of endothelial cell loss after intracapsular cataract extraction: A preliminary report . Acta Ophthalmol 1985;63:232-235.Crossref 6. Kraff M, Sanders D, Lieberman H: Monitoring for continuing cell loss with cataract extraction and intraocular lens implantation . Ophthalmology 1982;89:30-34.Crossref 7. Bourne W: Morphologic and functional evaluation of the endothelium of transplanted human corneas . Trans Am Ophthalmol Soc 1983;81:403-450. 8. Rao G, Shaw E, Arthur E, et al: Morphological appearance of the healing corneal endothelium . Arch Ophthalmol 1978;96:2027-2030.Crossref 9. Hoffer K: Vertical endothelial disparity . Am J Ophthalmol 1979;87:344-349. 10. Olsen T: Corneal thickness and endothelial damage after intracapsular cataract extraction . Acta Ophthalmol 1980;58:424-433.Crossref 11. Mishima S: Clinical investigations on the corneal endothelium . Am J Ophthalmol 1982;93:1-29. 12. Ohara K, Kanagami S, Tatsui T: The effects of intraocular surgery on the human corneal endothelium studied by scanning widefield specular microscopy , in Henkind P (ed): Acta: 24th International Congress of Ophthalmology . New York, JB Lippincott Co, 1982, vol 1, p 277. 13. Azen S, Hurt A, Steel D, et al: Effects of the Shearing posterior chamber intraocular lens on the corneal endothelium . Am J Ophthalmol 1983;95:798-802.Crossref 14. Schultz R, Matsuda M, Yee R, et al: Corneal endothelial changes in type I and type II diabetes mellitus . Am J Ophthalmol 1984;98:401-410.Crossref 15. Shaw E, Rao G, Arthur E, et al: The functional reserve of the corneal endothelium . Trans Am Acad Ophthalmol Otolaryngol 1978; 85:640-649. 16. Glasser D, Matsuda M, Ellis J, et al: Effects of intraocular irrigating solutions on the corneal endothelium after in vivo anterior chamber irrigation . Am J Ophthalmol 1985;99:321-328. 17. Rao G, Aquavella J, Goldberg S, et al: Pseudophakic bullous keratopathy: Relationship to preoperative corneal endothelial status . Ophthalmology 1984;91:1135-1140.Crossref 18. Sweeney D, Holden B, Vannas A, et al: The clinical significance of corneal endothelial polymegathism . Invest Ophthalmol Vis Sci 1985; 26( (suppl) ):53. 19. Schultz R, Matsuda M, Yee R, et al: Longterm survival of cryopreserved corneal endothelium . Ophthalmology 1985;92:1663-1667.Crossref 20. Matsuda M, Suda T, Manabe R: Serial alterations in endothelial cell shape and pattern after intraocular surgery . Am J Ophthalmol 1984;98:313-319.Crossref 21. Yee R, Matsuda M, Schultz R, et al: Changes in the normal corneal endothelial cellular pattern as a function of age . Curr Eye Res 1985;4:671-678.Crossref 22. Matsuda M, Sawa M, Edelhauser H, et al: Cellular migration and morphology in corneal endothelial wound repair . Invest Ophthalmol Vis Sci 1985;26:443-449. 23. Yee R, Geroski D, Matsuda M, et al: Correlation of corneal endothelial pump site density, barrier function, and morphology in wound repair . Invest Ophthalmol Vis Sci 1985;26:119-1201. 24. Honda H: Geometrical models for cells in tissues . Int Rev Cytol 1983;81:191-248. 25. Kaye G, Fenoglio C, Hoefle F, et al: Studies on the cornea: IX. Physiologic and morphologic effects of cytochalasin B on endothelium of rabbit corneas perfused in vitro . J Cell Biol 1974;61:537-543.Crossref 26. Van Horn D, Hyndiuk R: Endothelial wound repair in primate cornea . Exp Eye Res 1975;21:113-124.Crossref 27. Van Horn D, Sendele D, Seideman S, et al: Regenerative capacity of the corneal endothelium in rabbit and cat . Invest Ophthalmol Vis Sci 1977;16:597-613. 28. Tanimura K: A quantitative analysis of corneal endothelial cells . Folia Ophthalmol Jpn 1981;32:1835-1839. 29. Bourne W, Kaufman H: Specular microscopy of human corneal endothelium in vivo . Am J Ophthalmol 1976;81:319-323. 30. Matsuda M, Bourne W: Long-term morphologic changes in the endothelium of transplanted corneas . Arch Ophthalmol 1985;103:1343-1346.Crossref 31. Glasser D, Matsuda M, Gager W, et al: Corneal endothelial morphology after anterior chamber lens implantation . Arch Ophthalmol 1985;103:1347-1349.Crossref 32. Forstot S, Blackwell W, Jaffe N, et al: The effect of intraocular lens implantation on the corneal endothelium . Trans Am Acad Ophthalmol Otolaryngol 1977;83:195-203. 33. Drews R, Waltman S: Endothelial cell loss in intraocular lens placement . J Am Intraocul Implant Soc 1978;4:14-16.Crossref 34. Sugar A, Fetherolf E, Lin L, et al: Endothelial cell loss from intraocular lens insertion . Ophthalmology 1978;85:394-399.Crossref 35. Abbott R, Forster R: Clinical specular microscopy and intraocular surgery . Arch Ophthalmol 1979;97:1476-1479.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1986.01050200070053
Publisher site
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Abstract

Abstract • 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. References 1. Hirst L, Snip R, Stark W, et al: Quantitative corneal endothelial evaluation in intraocular lens implantation and cataract surgery . Am J Ophthalmol 1977;84:775-780. 2. Galin M, Lin L, Fetherolf E, et al: Time analysis of corneal endothelial cell density after cataract extraction . Am J Ophthalmol 1979;88:93-96. 3. Rao G, Stevens R, Harris J, et al: Long-term changes in corneal endothelium following intraocular lens implantation . Ophthalmology 1981; 88:386-397.Crossref 4. Liesegang T, Bourne W, Ilstrup D: Shortand long-term endothelial cell loss associated with cataract extraction and intraocular lens implantation . Am J Ophthalmol 1984;97:32-39. 5. Inaba M, Matsuda M, Shiozak Y, et al: Regional specular microscopy of endothelial cell loss after intracapsular cataract extraction: A preliminary report . Acta Ophthalmol 1985;63:232-235.Crossref 6. Kraff M, Sanders D, Lieberman H: Monitoring for continuing cell loss with cataract extraction and intraocular lens implantation . Ophthalmology 1982;89:30-34.Crossref 7. Bourne W: Morphologic and functional evaluation of the endothelium of transplanted human corneas . Trans Am Ophthalmol Soc 1983;81:403-450. 8. Rao G, Shaw E, Arthur E, et al: Morphological appearance of the healing corneal endothelium . Arch Ophthalmol 1978;96:2027-2030.Crossref 9. Hoffer K: Vertical endothelial disparity . Am J Ophthalmol 1979;87:344-349. 10. Olsen T: Corneal thickness and endothelial damage after intracapsular cataract extraction . Acta Ophthalmol 1980;58:424-433.Crossref 11. Mishima S: Clinical investigations on the corneal endothelium . Am J Ophthalmol 1982;93:1-29. 12. Ohara K, Kanagami S, Tatsui T: The effects of intraocular surgery on the human corneal endothelium studied by scanning widefield specular microscopy , in Henkind P (ed): Acta: 24th International Congress of Ophthalmology . New York, JB Lippincott Co, 1982, vol 1, p 277. 13. Azen S, Hurt A, Steel D, et al: Effects of the Shearing posterior chamber intraocular lens on the corneal endothelium . Am J Ophthalmol 1983;95:798-802.Crossref 14. Schultz R, Matsuda M, Yee R, et al: Corneal endothelial changes in type I and type II diabetes mellitus . Am J Ophthalmol 1984;98:401-410.Crossref 15. Shaw E, Rao G, Arthur E, et al: The functional reserve of the corneal endothelium . Trans Am Acad Ophthalmol Otolaryngol 1978; 85:640-649. 16. Glasser D, Matsuda M, Ellis J, et al: Effects of intraocular irrigating solutions on the corneal endothelium after in vivo anterior chamber irrigation . Am J Ophthalmol 1985;99:321-328. 17. Rao G, Aquavella J, Goldberg S, et al: Pseudophakic bullous keratopathy: Relationship to preoperative corneal endothelial status . Ophthalmology 1984;91:1135-1140.Crossref 18. Sweeney D, Holden B, Vannas A, et al: The clinical significance of corneal endothelial polymegathism . Invest Ophthalmol Vis Sci 1985; 26( (suppl) ):53. 19. Schultz R, Matsuda M, Yee R, et al: Longterm survival of cryopreserved corneal endothelium . Ophthalmology 1985;92:1663-1667.Crossref 20. Matsuda M, Suda T, Manabe R: Serial alterations in endothelial cell shape and pattern after intraocular surgery . Am J Ophthalmol 1984;98:313-319.Crossref 21. Yee R, Matsuda M, Schultz R, et al: Changes in the normal corneal endothelial cellular pattern as a function of age . Curr Eye Res 1985;4:671-678.Crossref 22. Matsuda M, Sawa M, Edelhauser H, et al: Cellular migration and morphology in corneal endothelial wound repair . Invest Ophthalmol Vis Sci 1985;26:443-449. 23. Yee R, Geroski D, Matsuda M, et al: Correlation of corneal endothelial pump site density, barrier function, and morphology in wound repair . Invest Ophthalmol Vis Sci 1985;26:119-1201. 24. Honda H: Geometrical models for cells in tissues . Int Rev Cytol 1983;81:191-248. 25. Kaye G, Fenoglio C, Hoefle F, et al: Studies on the cornea: IX. Physiologic and morphologic effects of cytochalasin B on endothelium of rabbit corneas perfused in vitro . J Cell Biol 1974;61:537-543.Crossref 26. Van Horn D, Hyndiuk R: Endothelial wound repair in primate cornea . Exp Eye Res 1975;21:113-124.Crossref 27. Van Horn D, Sendele D, Seideman S, et al: Regenerative capacity of the corneal endothelium in rabbit and cat . Invest Ophthalmol Vis Sci 1977;16:597-613. 28. Tanimura K: A quantitative analysis of corneal endothelial cells . Folia Ophthalmol Jpn 1981;32:1835-1839. 29. Bourne W, Kaufman H: Specular microscopy of human corneal endothelium in vivo . Am J Ophthalmol 1976;81:319-323. 30. Matsuda M, Bourne W: Long-term morphologic changes in the endothelium of transplanted corneas . Arch Ophthalmol 1985;103:1343-1346.Crossref 31. Glasser D, Matsuda M, Gager W, et al: Corneal endothelial morphology after anterior chamber lens implantation . Arch Ophthalmol 1985;103:1347-1349.Crossref 32. Forstot S, Blackwell W, Jaffe N, et al: The effect of intraocular lens implantation on the corneal endothelium . Trans Am Acad Ophthalmol Otolaryngol 1977;83:195-203. 33. Drews R, Waltman S: Endothelial cell loss in intraocular lens placement . J Am Intraocul Implant Soc 1978;4:14-16.Crossref 34. Sugar A, Fetherolf E, Lin L, et al: Endothelial cell loss from intraocular lens insertion . Ophthalmology 1978;85:394-399.Crossref 35. Abbott R, Forster R: Clinical specular microscopy and intraocular surgery . Arch Ophthalmol 1979;97:1476-1479.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Aug 1, 1986

References

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