Abstract
Summary The corneal endothelium maintains corneal transparency by providing a fluid barrier between the aqueous humor and the corneal stroma. Loss of funtional integrity of this cell layer results in corneal edema and a reduction in visual acuity. Because the corneal endothelial cells appear not to replicate by cell division, damaged areas heal only by the enlargement and spreading out of the remaining cells. Thus, there is a limit to the “healing reserve” of the endothelium and excessive surgically-induced trauma coupled with natural cell losses due to aging can result in loss of endothelial function and corneal decompensation. Contact between corneal endothelial cells and the intraocular lens during lens insertion causes stripping of the cell membranes and cell death. Prevention of this damage can be obtained through improved surgical techniques and modifications of intraocular lens surfaces. In addition, studies are in progress to find ways to stimulate endothelial cell regeneration.
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