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.