Objective To investigate the security of phacoemulsification and intraocular lens implantation for cataract with very low corneal endothelial cells density after penetrating keratoplasty(PKP). Methods The clinical data of 11 patients of cataract after PKP with corneal endothelial cells density less than 1 000/mm2 accepted phacoemulsification and intraocular lens implantation were retrospectively analyzed.Among these patients

the average corneal endothelial cell density was 772.64 per square millimeter

and the lowest one was 579 per square millimeter.All the patients underwent phacoemulsification combined with intraocular lens implantation

and the vision improvement and corneal recovery of patients were observed. Results At 3 months after cataract surgery

the average corneal endothelial cell density statistically decreased from (772.64±134.49) per square millimeter preoperatively to (717.45±130.57) per square millimeter

and the difference was statistically significant (P<0.05).The average rate of endothelial cell loss was 7.57%.There was no significant difference in central corneal thickness before and after surgery (P>0.05).No corneal endothelial decompensation or corneal graft rejection occurred.The best corrected visual acuity was all above 0.1 at 3 months after the operation

which was significantly improved. Conclusion Phacoemulsification combined with intraocular lens implantation for cataract with corneal endothelial cells density less than 1000 per square millimeter after PKP was feasible with carefully protection of the corneal endothelial cells during surgery and intensively perioperative observation and treatment.