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/mm) of the PK-CAT group was significantly higher than that in the CED subgroup (632.50 ± 238.29 cells/mm) 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.