A Comparison of Endothelial Cell Loss After Phacoemulsification in Penetrating Keratoplasty Patients and Normal Patients

PURPOSE: To compare phacoemulsification-related endothelial cell loss in transplanted corneas and normal corneas. METHODS: Forty-nine patients who underwent phacoemulsification/intraocular lens insertion after penetrating keratoplasty (PK-CAT group) (50 eyes) were compared with 65 patients who underwent phacoemulsification/intraocular lens insertion only (CAT group) (100 eyes). The PK-CAT group was divided into corneal endothelial dysfunction (CED) and opacity subgroups according to recipient endothelial function. Effective phacoemulsification time and endothelial density were analyzed. RESULTS: The endothelial cell density after cataract surgery from 1 month (1772.72 +/- 315.89) to 24 months (917.25 +/- 372.75) in the PK-CAT group was significantly lower than that before cataract surgery (2189.36 +/- 358.68) (P < 0.05) but that in CAT group was not significantly different from baseline during follow-up time (P < 0.05). The rate of graft survival in the opacity subgroup (82.0%) of the PK-CAT group was higher than that in the CED subgroup (54.5%) after 2 years (P < 0.05). The mean endothelial density in the opacity subgroup (1216.73 +/- 271.63 cells/mm2) of the PK-CAT group was significantly higher than that in the CED subgroup (632.50 +/- 238.29 cells/mm2) at 2 years after cataract surgery (P < 0.05). CONCLUSIONS: The phacoemulsification-related endothelial cell loss in transplanted corneas was higher than that in normal corneas. A possible factor contributing to higher endothelial cell loss in transplanted corneas is recipient endothelial dysfunction.