Objective: To study the effect of exogenously applied hyaluronic acid (HA) on corneal endothelial cells in experimental
cataract surgery in eye-bank eyes. Design: Hyaluronic acid is endogenous to the eye. Histochemically a thin layer of
hyaluronic acid can be observed coating the inner surface of corneal endothelial cells. After standardized experimental cataract surgery the endothelial cells were studied with histochemical technique. Results: When instilled in the anterior chamber, HA binds to the endothelial cells. The HA can be removed from the endothelial cells by increasing volumes of irrigation/aspiration. If reinjected into the anterior chamber, the HA will again bind and protect the endothelial cells. A clear endothelial morphologic difference can be shown when surgical trauma is inflicted on the cornea with and without the protection of HA. Conclusion: The experiments demonstrate that HA binds to and protects the corneal endothelial cells. The results also indicate that when exogenous HA is irrigated/aspirated from the anterior chamber at the end of the procedure, a thin layer of HA remains on the endothelial cells.