LONG-TERM CORNEAL ENDOTHELIAL CHANGES AFTER INTRAOCULAR-LENS IMPLANTATION - ANTERIOR VS POSTERIOR CHAMBER LENSES

The use of semiflexible anterior chamber intraocular lenses, widesprea d during the early 1980's, has been abandoned due to the many complica tions associated with their use. Patients who received these lenses cu rrently represent the majority of patients with pseudophakic bullous k eratopathy. We studied the morphologic characteristics of the corneal endothelium in 20 patients who had undergone extracapsular cataract ex traction followed by anterior chamber or posterior chamber intraocular lens implantation. Specular microscopy and computer-assisted morphome try were performed preoperatively, 3 months postoperativety, and once a year thereafter. The follow-up period for each subject was 5 years o r longer. The endothelial cell density of the central cornea in the an terior chamber lens group decreased from 304 to 196 (X 10 cells/mm2), and in the posterior chamber lens group decreased from 315 to 269 (X 1 0 cells/mm2). Four patients in the anterior chamber lens group develop ed pseudophakic bullous keratopathy 6 or 7 years after surgery. Severe endothelial cell loss and morphologic change were seen in patients wh o received anterior chamber lenses.