Posters

Simultaneous cataract surgery with IOL implantation and penetrating keratoplasty, triple procedure outcomes, method for achieving the intended postoperative refractive result

Poster Details

First Author: A. Lotfi ARGENTINA

Co Author(s):    A. Cruz Fourcade   C. Gordillo   M. Erice   N. Landeiro   J. Grandin        

Abstract Details

Purpose:

To describe the outcomes of phacoemulsification and intraocular lens (IOL) implantation in simultaneous with penetrating keratoplasty (PKP), triple procedure.

Setting:

This is a retrospective study on patients who had undergone a triple procedure. All surgeries were performed by the same surgeon at Zaldivar Institute (Mendoza, Argentina)

Methods:

Preoperative keratometry readings, theoretical keratometric values and axial length, SRK-T or Zaldivar own formula were used to calculate IOL power. We used in the formula for calculating the intraocular lens, 1mm to 1,5 mm less than the preoperative axial length. The cataract extraction technique consisted of anterior capsulorhexis, phacoemulsification and IOL placed within the capsular bag in all cases. For PKP, the host tissue was removed with a 0.25 to 0.50mm graft-host disparity. Interrupted 10-0 nylon sutures were performed. Outcome measures included uncorrected and corrected distance visual acuity (CDVA), refractive results, keratometric values, graft clarity and complications.

Results:

12 eyes of eleven patients were included. Mean patient age was 60,33 years (range 22 – 74) and the follow-up period of at least 12 months. There was a significant increase in CDVA (from mean 0.9 logMAR to 0.4 logMAR SD 0.5, (P=0,001). There was a significant decrease in keratometric astigmatism from mean 48 (range 44.37 to 51,62) to 43,37 (range 41.62 - 45.1). Spherical error was reduced from mean -6.75 D to mean -0.75 D. All measurements were performed at 12 months of postop. At final follow-up, 91,66 % of the corneal grafts remained clear.

Conclusions:

The triple procedure is a safe and effective approach that provides faster rehabilitation to restore vision in patients with coexisting corneal pathology and cataract. IOL power can be calculated using theoretical K values provided by the surgeon as a safe method, however, postoperative refractive error can be anticipated.

Financial Disclosure:

NONE