A Clinical Study Of Complicated Cataract After Penetrating Keratoplasty

ObjectiveTo observe and analysis the PKP primary etiology and the occurring time of complicated cataract time as well as the efficacy and safety of extracapsular cataract extraction(ECCE) and phacoemulsification (PHACO) for the patients with complicated cataract after penetrating keratoplasty.Materials and MethodsCollect and retrospectively analyze the data of24patients who had accepted cataract extraction and IOL implantation from Jan2011to Dec2013in the Qilu Hospital of Shandong University.24patients with complicated cataract after PKP were divided into two groups (ECCE group and PHACO group) and respectively accepted extra-capsular extraction and phacoemulsification and intraocular lens implantation after completion of preoperative examination and preparation.Regular follow-up, recording and comparatively analyze the postoperative visual acuity, corneal endothelial cell count and corneal astigmatism of each group.ResultsThe PKP primary etiology and the occurring time of complicated cataract:13cases of infective keratitis (54.17%),11cases had occurred cataract within1years (84.62%),2cases (15.38%) occurred after more than1year;5patients of trauma and corneal leukoma (20.83%),3cases had occurred cataract within1years (60%),2cases (40%) occurred after more than1year;4cases of corneal graft rejection (16.67%),3cases had occurred cataract within1years (75%),1cases (25%) occurred after more than1year; there was1case in each of corneal degeneration or malnutrition, bullous keratopathy (4.17%), complicated cataract all occurred within1years after PKP.The efficacy, safety in ECCE group and PHACO group:The differences of preoperative and postoperative best corrected visual acuity have statistical significance in both ECCE group and PHACO group. The ratio of the cases whose best corrected visual acuity3months after the surgery≥0.4are respectively78.57%(PHACO group) and80%(ECCE group), and there was no difference in the statistical test. The corneal endothelial cell loss rate3months after the surgery of the two groups are respectively (10.01±2.8)%(PHACO group) and (7.8±2.4)%(ECCE group), there was significant difference between the two groups. The average degree of corneal astigmatism3months after the surgery are respectively (4.17±2.10) D (PHACO group) and (5.17±2.19) D (ECCE group), and there was significant differences between the two group in the statistical test.ConclusionsThe most common PKP primary etiology in the patients with complicated cataract is infective keratitis. The complicated cataract mostly occurs within1year after the penetrating keratoplasty. The kinds of PKP primary etiology have no obvious effect on the occurring time of complicated cataract.The effects of ECCE and phacoemulsification on treating complicated cataract are both very obvious, and the safeties of the two kinds of operation are both satisfied. Significantly, the phacoemulsification operation shows a more serious damage to corneal endothelial cell and a smaller astigmatism than the extracapsular cataract extraction.