Corneal endothelial cell loss in eyes undergoing lensectomy with and without anterior lens capsule removal combined with pars plana vitrectomy and gas tamponade

Purpose: To assess prospectively the corneal endothelial damage associated with pars plana vitrectomy combined with lensectomy and gas tamponade. Methods: The corneal endothelium was examined with a specular microscope preoperatively and 6 months postoperatively in 42 eyes that underwent pars plana vitrectomy combined with total lensectomy and gas tamponade with SF6 (19 eyes) or C3F8 (23 eyes), and in 12 control eyes that underwent vitrectomy combined with anterior capsule-preserved lensectomy and gas tamponade. Results: The mean +/- SD endothelial cell loss was 17.19 +/- 7.88% in the SF6 tamponade group, 21.54 +/- 10.57% in the C3F8 tamponade group, and 3.49 +/- 2.68% in the control group. Significant differences were found in the mean cell loss among these three groups. The degree of cell loss was significantly related to gas tamponade duration in the eyes with total lensectomy. Conclusion: These results suggest that ophthalmic surgeons must try to preserve the lens capsule as much as possible in vitrectomy combined with lensectomy and long-acting gas tamponade in order to prevent corneal endothelial damage.