Clinical specular microscopy and intraocular surgery.

Seventy patients were studied prospectively, using the clinical specular microscope, to compare and evaluate the effects on the corneal endothelium of routine intracapsular cataract extraction (ICCE), ICCE with intraocular lens (IOL) implantation, phacoemulsification, and penetrating keratoplasty. Results showed a 6% cell loss after ICCE, 12% loss after IOL insertion, 14% after phacoemulsification, and 21% loss after penetrating keratoplasty. Both phakic and aphakic grafts had 21% cell loss. Within the aphakic keratoplasty group, there was a 10% cell loss in patients who maintained an intact vitreous face compared with a 26% cell loss in patients who underwent an anterior vitrectomy (P less than .1).