• Specular microscopy was used to study the corneal endothelium in a series of patients undergoing phacoemulsification with and without intraocular lens implantation by one experienced surgeon. Cell loss after phacoemulsification alone was variable, but the mean was 18%, with a median of 11%. The patients undergoing phacoemulsification plus lens implantation showed a mean cell loss of 26%, with a median of 17%. This is considerably lower than has been reported with standard intracapsular extraction plus lens implantation. The decreased endothelial damage is attributed to the technique of inserting the lens through a small incision and maintaining an air bubble between the lens and the cornea throughout lens insertion and wound closure.
Irvine AR, Kratz RP, O'Donnell JJ. Endothelial Damage With Phacoemulsification and Intraocular Lens Implantation. Arch Ophthalmol. 1978;96(6):1023-1026. doi:10.1001/archopht.1978.03910050547011