title: Toxic endothelial cell destruction of the cornea after routine extracapsular cataract surgery.
abstract: Eighteen patients developed an acute corneal decompensation following normal intraocular surgery (cataract extraction in 17 patients), characterized by star-shaped endothelial folds, a twofold increase in corneal thickness, and a visual acuity of counting fingers during several postoperative days. In some cases, there was an additional iritis and transient hypotony. There was no effect of topical and/or subconjunctival corticosteroids on the course of the decompensation. Endothelial morphometric analysis showed a mean endothelial cell loss of 72%. Endothelial wound healing, as determined by coefficient of variation and percentage hexagonals, stabilized 6 months postoperatively. We coined the term toxic endothelial cell destruction for this syndrome. Epidemiological evaluation revealed the toxic endothelial cell destruction syndrome to be linked with the 10-fold increase of a detergent solution in the ultrasonic bath for cleaning the surgical instruments.
authors.affiliation: Department of Ophthalmology, University of Amsterdam, The Netherlands.
authors.forename: A C
authors.initials: AC
authors.lastname: Breebaart
authors.forename: R M
authors.initials: RM
authors.lastname: Nuyts
authors.forename: E
authors.initials: E
authors.lastname: Pels
authors.forename: H F
authors.initials: HF
authors.lastname: Edelhauser
authors.forename: F D
authors.initials: FD
authors.lastname: Verbraak
mesh_terms: D000368:Aged; D002387:Cataract Extraction / Q000379:methods; D002470:Cell Survival; D003316:Corneal Diseases / Q000139:chemically induced*; D003902:Detergents / Q000009:adverse effects*; D004728:Endothelium, Corneal / Q000187:drug effects / Q000473:pathology* / Q000648:ultrastructure; D005260:Female; D006801:Humans; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011183:Postoperative Complications; D013501:Surface-Active Agents / Q000009:adverse effects*; D013525:Surgical Instruments
chemical_list: D003902:Detergents; D013501:Surface-Active Agents