Long-term changes in corneal endothelium following intraocular lens implantation.

To understand the long-term effects of intraocular lens implantation on corneal endothelium, 52 eyes with intraocular lens implantations and 35 eyes with simple cataract extractions were studied using clinical specular microscopy. Endothelial photographs were obtained preoperatively and at least four times in the postoperative period in each case. The postoperative period ranged from 16 to 43 months. Our observations demonstrated that intraocular implants produce a greater magnitude of endothelial cell damage and iris-supported lenses have a more deleterious effect on the corneal endothelium compared with anterior chamber lenses. Seventy-one percent of the eyes with intraocular implants demonstrated precipitates on the endothelium with 16% developing guttata-like areas. All these changes were progressive with time with no such phenomenon occurring in eyes with simple cataract extractions. The progressive endothelial cell damage may be a sequel of chronic, smoldering uveitis associated with intraocular implants.