Corneal complications following cataract surgery and intraocular lens implantation continue to be more unusual because of advances in our surgical techniques. Complications can still occur, however, and can include mechanical or toxic injury of the endothelium, stripped Descemet's membrane, epithelial toxicity and disruption, infectious keratitis, and epithelial ingrowth. Endothelial cell survival after cataract extraction and lens implantation are still major concerns. Healing of the cornea following clear corneal incisions has become more important as this technique is more frequently used, and several studies are looking at the results of clear corneal incisions performed for cataract surgery. Patients with ocular surface disease still require extra lubrication and management of blepharitis to prevent epithelial toxicity at the time of surgery as well as postoperatively. As incisions move back to the cornea from the distant limbus, careful observation for complications involving the cornea will be needed. Still, modern day cataract extraction and lens implantation are extremely gentle on the cornea.