Changes of corneal endothelium after secondary intraocular lens implantation of traumatic aphakia

Purpose To find out the changes of corneal endothelium after secondary intraocular lens implantation for posttraumatic aphakia. Methods Twenty-four patients with traumatic aphakia were included in this study. Photographs were taken at 5 points area of cornea. Endothelial density was measured before and after the operation. Results Twenty-one patients were included in this study. Eleven patients underwent the operation of PMMA lens implantation through superior corneoscleral incision, while ten patients underwent the operation of transcleral fixation of PMMA intraocular lens with intraocular infusion. The endothelial cell density near the corneal wound and superior cornea was significantly lower than that of other paracentral cornea. About 129.2 cells/mm^2 loss one week after the operation, and about 114.Scellsdmm^2 loss between the interval of one week and one month postoperatively. More 124 cells/mm^2 loss in group of transcleral fixation Of PMMA lens with intraocular infusion compared with the group of PMMA lens intraocular implantation without fixation and infusion. Cell loss during the surgery was negatively correlated to the preoperative cell density. Conclusions Corneal endothelial cell loss during the secondary intraocular implantation is negatively correlated to the preoperative cell density. And the incision should deviate from the site of corneal penetrating wound. Multiple points measurement of corneal endothelium density is recommended in posttraumatic aphakia preoperatively. The preoperative ECD should be larger than 1120cells/mm^2 in patients who will undergo secondary lens implantation; and 1220cells/mm^2 in patients who will undergo lens implantation with sulcus fixation and intraocular irrigation. Key words: Corneal endothelium;  Intraocular lens implantation