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August 1979

Use of Air to Decrease Endothelial Cell Loss During Intraocular Lens Implantation

Author Affiliations

From the Sections of Ophthalmology (Drs Bourne and Brubaker) and Medical Research Statistics (Dr O'Fallon), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Arch Ophthalmol. 1979;97(8):1473-1475. doi:10.1001/archopht.1979.01020020135009

• We performed 26 consecutive intracapsular cataract extractions with lens implantation. The last 17 implantations were performed with air instilled in the anterior chamber, whereas the first nine operations were performed without air. The central corneal endothelium of each eye operated on was photographed before and within five days after lens implantation. A computer analysis of the endothelial photographs showed that, on the average, 32% of the central corneal endothelial cells were lost during lens implantation without the use of air and 15% were lost when the lens was implanted with air. Increased endothelial cell loss was significantly correlated with the failure to implant the lens with use of air, with increased operative endothelial trauma, and with higher postoperative intraocular pressures. A significantly larger increase in corneal thickness on the first postoperative day occurred in patients with larger or more varied cell sizes preoperatively.

Bourne WM, Kaufman HE:  Endothelial damage associated with intraocular lenses . Am J Ophthalmol 81:481-485, 1976.
Bourne WM, Kaufman HE:  Cataract extraction and the corneal endothelium . Am J Ophthalmol 82:44-47, 1976.
Cheng H, Sturrock GD, Rubinstein B, et al:  Endothelial cell loss and corneal thickness after intracapsular extraction and iris clip lens implantation: A randomized controlled trial (interim report) . Br J Ophthalmol 61:785-790, 1977.Article
Forstot SL, Blackwell WL, Jaffe NS, et al:  The effect of intraocular lens implantation on the corneal endothelium . Trans Am Acad Ophthalmol Otolaryngol 83:195-203, 1977.
Drews RC, Waltman SR:  Endothelial cell loss in intraocular lens placement . Am Intraocular Implant Soc J 4:14-16, 1978.Article
Sugar A, Fetherolf EC, Lin LLK, et al:  Endothelial cell loss from intraocular lens insertion . Ophthalmology 85:394-399, 1978.Article
Aquavella JV, Shaw EL:  A technique for treating positive vitreous pressure during intraocular lens implantation in intracapsular surgery . Ophthalmic Surg 8:78-80, 1977.
Hirst LW, Snip RC, Stark WJ, et al:  Quantitative corneal endothelial evaluation in intraocular lens implantation and cataract surgery . Am J Ophthalmol 84:775-780, 1977.
Irvine AR, Kratz RP, O'Donnell JJ:  Endothelial damage with phacoemulsification and intraocular lens implantation . Arch Ophthalmol 96:1023-1026, 1978.Article
Binkhorst CD, Loones LH, Nygaard P:  Biomicroscopical observations on corneal endothelium in pseudophakia . Trans Ophthalmol Soc UK 97:67-73, 1977.
Binkhorst CD, Nygaard P, Loones LH:  Specular microscopy of the corneal endothelium and lens implant surgery . Am J Ophthalmol 85:597-605, 1978.
Rao GN, Shaw EL, Arthur EJ, et al: Endothelial cell morphology and corneal deturgescence. Ann Ophthalmol, in press.
Sugar J, Mitchelson J, Kraff M:  Endothelial trauma and cell loss from intraocular lens insertion . Arch Ophthalmol 96:449-450, 1978.Article
Bourne WM, Kaufman HE:  Specular microscopy of human corneal endothelium in vivo . Am J Ophthalmol 81:319-323, 1976.
Mishima S, Hedbys BO:  Measurement of corneal thickness with the Haag-Streit pachometer . Arch Ophthalmol 80:710-713, 1968.Article
Bourne WM, Enoch JM:  Some optical principles of the clinical specular microscope . Invest Ophthalmol 15:29-32, 1976.
Bourne WM, O'Fallon WM:  Endothelial cell loss during penetrating keratoplasty . Am J Ophthalmol 85:760-766, 1978.
Leibowitz HM, Laing RA:  Corneal endothelium: The effect of air in the anterior chamber . Arch Ophthalmol 92:227-230, 1974.Article
Kraff MC, Sanders DR, Lieberman HL:  Endothelial cell loss and trauma during intraocular lens implantation: A specular microscopic study . Am Intraocular Implant Soc J 4:107-109, 1978.Article
Kirsch RE:  Glaucoma following cataract extraction associated with use of alpha-chymotrypsin . Arch Ophthalmol 72:612-620, 1964.Article
Shaw EL, Rao GN, Arthur EJ, et al:  The functional reserve of corneal endothelium . Ophthalmology 85:640-649, 1978.Article