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TWO papers in this issue of the Archives (pp 3-9) report on cataract cryoextraction and the complications encountered. Both agree that the incidence of capsular rupture is reduced by cryoextraction. On the other hand, one paper reports an alarmingly high incidence of irreversible corneal edema following cataract cryosurgery while the other paper scarcely mentions any problem concerned with the cornea. In view of the increasing popularity of this technique, this apparent discrepancy deserves further explanation.
Taylor and Dalburg report an incidence of 4.5% of postoperative corneal edema, often progressing to severe bullous keratopathy, in a series of 200 cases employing one of three types of cryoextractors. In a larger control series, the authors report an incidence of corneal edema of only 0.66%. Their speculation based on certain animal experimentation in the literature, is that freezing or excessive chilling of the corneal endothelium was the factor responsible for the greater incidence