[Cataract and corneal endothelium].
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Biomedical subjects
Publications and source records attributed to J C Cornic.
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The Zeiss keratometer is easy to use with simple and fast reading. The preoperative keratometry principle is satisfactory by allowing theorically a better control of surgical factors of postoperative astigmatism after cataract surgery. Its major interest appears in surgical training, when one wants to compensate a preoperative astigmatism or when one wishes to avoid secondary suture removal. However, its interest is very variable according to surgical experience.
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The mode of the intra-ocular lens surgery is conditioned by the progresses of the fabrication methods and the lack of an ideal optical correction of the aphakia. Incidents and accidents of the method can be lessened by a good knowledge of the fabrication and optical necessities and also by a very strong selection of the patients and a good surgery training.
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The various traumatic lesions occurring in the corneal endothelium during phacoemulsification were studied in the eyes of anesthetized rabbits. A comparison was made between the effects of massive perfusion of the anterior chamber with simple isotonic saline or Earle's solution, ultrasound emission, total phacoemulsification, and classical extracapsular extraction. The endothelium was examined by electronic scanning microscopy to cover large areas of the endothelium. Simple perfusion with Earle's solution does not alter the appearance of the endothelium, though some modifications in apical digitations may be observed. Perfusion with isotonic saline solution for 15 minutes modifies the appearance of the endothelial surface, with early necrosis in several cells. Ultrasounds provoke complete necrosis of a few isolated cells but do not cause major changes in most of them. Phacoemulsification produces endothelial ulcerations, probably from the trauma from lens debris. Extracapsular extraction, difficult in the rabbit, is the cause of much larger lesions with cell necrosis and vast areas of ulceration.
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