Effect of intraocular lenses on the corneal endothelium.

Methacrylate surfaces adhere to corneal endothelial cell membranes and appear to tear off the cell membranes as they separate. This adhesion appears to cause much of the massive cell damage seen at the time of intraocular lens insertion even in the hands of several groups of very experienced implant surgeons. The damage appears correlated with the incidence of endothelial touch, and may be avoidable both by avoiding contact, even for a brief period, between the endothelium and the intraocular lens during insertion, and by increasing the safety of such lenses through a hydrophilic protective coating which would give a surface similar to human lens epithelium or soft contact lens material which does not damage the endothelium. It is possible that similar damage also plays a role in causing abdominal adhesions through contact with rubber gloves, as well as venous thromboses and urethral strictures.