Specular microscopy following endophthalmitis

Introduction: Since the first reports of specular microscopic photographs i n vivo of the corneal endothelium, endophthalmitis is said to damage endoth elial cells irreversibly. Patients and method: We controlled 29 eyes 1 to 10 years after endophthalmi tis following cataract surgery using specular microscopy. We tried to find out, if endophthalmitis leads to significant endothelial damage and we want ed to describe the in-vivo-cytological follow-up of the implanted lenses. Results: Endothelial cell-density of the eyes with endophthalmitis (n = 29) was 2733/mm(2) (+/- 680). In those eyes receiving cataract-surgery without endophthalmitis in the fellow eye (n = 14), the endothelial density was 28 51/mm(2) (+/- 360). If the fellow eye has had no cataract surgery (n = 13), cell density was 3110/mm(2) (+/- 750). Hypopyon-iritis after cataract-surg ery did not decrease endothlial cell count significantly more than cataract -surgery without hypopyon-iritis (p>0.05). At the last control at least one year after surgery, 36% of all IOLs were free of any cellular deposits. Th ere was no case of a foreign-body-reaction. Conclusion: In our patients, postoperative endophthalmitis has not led to s ignificant endothelial damage. In none of our patients, endophthalmitis has led to chronic foreign-body reaction against the implant or to granulomato us uveitis. Specular microscopy of the corneal endothelium and of the impla nted lens may help to differentiate in the case of postoperative inflammati on between an infection and a foreign-body-reaction. In the case of a steri le foreign-body-reaction, there are no inflammatory cells on the endotheliu m or in the anterior chamber.