Cataract Surgery in Eyes with Corneal Endothelial Disorders

Purpose: To investigate the outcome of cataract surgery in patients with corneal endothelial disorders. Subjects and methods: Twenty patients (29 eyes) with Grade 2 or 3 (corneal endothelial cell density <1,000 cells/mm2) corneal endothelial disorders underwent cataract surgery from 2009 to 2013 at Juntendo Hospital without complications and were followed for ≥1 year. We retrospectively investigated demographic data, visual acuity, endothelial cell density, and bullous keratopathy. Results: At 1 year postoperatively, mean visual acuity was 0.43 and the mean decrease of endothelial cell density was 13.9±14.5%. In 5 eyes with bullous keratopathy (17.2%), the mean time until onset was 3.0±3.7 months. Grade 3 patients had a significantly higher incidence of bullous keratopathy and more advanced hardening of the lens nucleus than Grade 2 patients. Conclusions: Cataract patients with severe corneal endothelial disorders often present advanced nuclear hardening whereas bullous keratopathy occurs relatively early after cataract surgery. Timing of surgery needs to be determined while taking these factors into consideration.