The phacoemulsification procedure. III. Corneal complications.

Persistent corneal edema is one of the complications of phacoemulsification. Five patients underwent this procedure 6 to 8 months before keratoplasty was performed. In addition to bullous keratopathy, two corneas had corneal scarring due to probe overheating or corneal vascularization of the anterior chamber. Electron microscopy of corneal specimens showed that four cases had Fuch's dystrophy without warts and one had guttata. Endothelial cell destruction varied from lessions of small size (15 to 50 mu) to large abrasions. Cases with severe edema and vitreous adhesion showed retrocorneal membrane formation. Surgical trauma seemed to have precipitated decompensation of these dystrophic corneas.