Corneal endothelial cell loss, cystoid macular edema, and iris-supported intraocular lenses.
Endothelial cell loss, persistent cystoid macular edema and a chronic low-grade uveitis may complicate intracapsular cataract extraction combined with iris supported intraocular lenses. Clinical examination of 19 eyes of 17 patients, at 1.1 to 5 years after cataract surgery, and correlation with wide field specular microscopy and fluorescein angiography, documents this problem. The mean central corneal endothelial cell count was 497 cells/mm2 (standard deviation, 119). In ten cases, focal edema was localized to the corneal periphery. Cystoid macular edema was present in all but one case. Intermittent cornea/implant touch or low-grade intraocular inflammation, possibly from iris/implant contact, may explain the natural history of the endothelial cell loss and cystoid macular edema. Monitoring endothelial cell counts and macular function in patients with iris-supported implants may afford the early recognition of this problem. In such cases, early implant removal may alter the natural history and preserve corneal and macular function.
D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects*; D002452:Cell Count; D003315:Cornea / Q000166:cytology; D003316:Corneal Diseases / Q000209:etiology*; D004487:Edema / Q000209:etiology; D004727:Endothelium / Q000166:cytology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007498:Iris; D007634:Keratitis / Q000209:etiology; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008269:Macular Edema / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors