Corneal endothelial cell loss in post-penetrating keratoplasty patients after cataract surgery: Phacoemulsification versus planned extracapsular cataract extraction

PurposeTo compare the changes in endothelial cell density (ECD) in post-penetrating keratoplasty (PKP) patients after cataract extraction with phacoemulsification or planned extracapsular cataract extraction (ECCE).SettingHaydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey.DesignClinical trial.MethodsEyes with hard nuclear cataract that had previous PKP were randomly assigned to have phacoemulsification or ECCE. Noncontact specular microscopy was performed preoperatively and 1, 3, and 6 months postoperatively.ResultsTwenty-six eyes of 26 patients were enrolled (14 phacoemulsification; 12 ECCE). Six months postoperatively, the mean corneal ECD was statistically significantly lower in the phacoemulsification group (1869.50 cells/mm2 ± 158.05 [SD]) than in the ECCE group (1996.00 ± 127.96 cells/mm2) (P=.024). The mean percentage of endothelial cell loss at 6 months was 20.3% and 12.7%, respectively (P<.05). In both groups, there was no significant difference in the percentage hexagonality between preoperatively and postoperatively (P>.05).ConclusionExtracapsular cataract extraction seemed to cause less endothelial cell damage than phacoemulsification in post-PKP patients with hard nuclear cataract.Financial DisclosureNo author has a financial or proprietary interest in any material or method mentioned.