Corneal Triple Procedure: Indications, Complications, and Outcomes

Sridhar, Magadi Gopalakrishna; Murthy, Somasheila; Bansal, Akash; Rao, Gullapalli N

doi:10.1097/00003226-200005000-00015

Cited by 19 publications

(13 citation statements)

References 7 publications

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“…In India, corneal scarring caused by infection, trauma, and malnutrition is the predominant indication for corneal transplant surgery, 27,28 accounting for 66% of surgeries in one series. 29 Similarly, in Zimbabwe, scarring from measles, keratitis, or trauma comprised 39.3% of PK cases. In our study, corneal scar and adherent leukoma together comprised 72.6% of all cases.…”

Section: Discussionmentioning

confidence: 99%

Penetrating Keratoplasty in Nepal

Tabin¹,

Gurung²,

Paudyal³

et al. 2004

Cornea

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Section: Discussionmentioning

confidence: 99%

Penetrating Keratoplasty in Nepal

Tabin¹,

Gurung²,

Paudyal³

et al. 2004

Cornea

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“…8,10,16,17,29,33 Serdarevic et al 15 reported that all of their patients achieved BCVA X6/12. They hypothesised a correlation existed between the preoperative dioptric power of peripheral recipient corneas and the postoperative central power of grafted donor corneas and used videokeratoscopic analysis of peripheral recipient corneas to determine IOL power.…”

Section: Bcvamentioning

confidence: 98%

“…The 5-year graft survival was 85% for both groups, which compares well with published triple procedure survival rates of 69-100% over variable follow-up periods. 5,[8][9][10][11]16,18,22,23,[29][30][31][32][33]42,46 The 2007 Australian Corneal Graft Registry 47 reported 1-and 5-year graft survivals of 89 and 78%, respectively, for triple procedure. Sequential surgery has been associated with increased graft endothelial cell count loss, and graft failure as high as 13-21%.…”

Section: Graft Survivalmentioning

confidence: 99%

The visual and refractive outcomes of combined and sequential penetrating keratoplasty, cataract extraction, and intraocular lens insertion

Nguyen

Mumford

Jones

et al. 2008

Eye

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Purpose The aim of this study was to investigate the visual and refractive outcome of combined penetrating keratoplasty, cataract extraction, and intraocular lens insertion (triple procedure) compared with cataract surgery following penetrating keratoplasty (sequential surgery). Methods Retrospective cohort study of 1256 first penetrating keratoplasty for Fuchs' dystrophy performed between April 1999 and December 2005. In all, 1202 triple and 54 sequential procedures were reviewed. At 1 year, refractive outcomes were available for 499 triple procedure and 26 sequential surgery eyes. At 2 years, data were available for 264 triple procedure and 10 sequential surgery eyes. At 1 and 2 years postoperatively, graft survival, best-corrected visual acuity (BCVA), spherical equivalent, and cylindrical error were recorded. v 2 -Tests were used to compare visual outcomes between the two groups.Results At 1 year after triple procedure surgery, 61% of eyes attained BCVA of X6/12, with 47% of eyes within±2 D of emmetropia. After sequential surgery, 59% achieved BCVA of X6/12 with 67% of eyes within±2 D of emmetropia ( ¼ 0.05). Mean spherical equivalent (MSE) at 1 and 2 years after triple procedure was þ 1.20 D (SD 5.45) and þ 0.15 D (SD 3.58), respectively. MSE following sequential surgery at 1 and 2 years was þ 0.08 D (SD 3.06) and À1.50 D (SD 3.14), respectively. Mean refractive cylinder after combined surgery was þ 4.16 D (SD 5.11) and þ 3.91 D (SD 2.79) at 1 and 2 years, respectively, compared with þ 3.65 D (SD 2.24) and þ 3.70 D (SD 2.06) after sequential surgery. In all, 29% of triple procedure and 27% sequential surgery eyes had an astigmatic error X5.0 D after 1 year (P ¼ 0.64), which increased to 34 and 30%, respectively, by the second year. The 5-year graft survival was 85% in both groups. There were no differences in graft survival, visual or refractive outcomes between triple procedure, and sequential surgery techniques. Conclusions This analysis provided no evidence of improved visual or refractive outcome after sequential surgery compared with triple procedure.

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“…RB Vajpayee and others (2001) in their study reported 70% cases with postoperative visual acuity of 6/12 or better at 1 yr. follow up. Sridhar MS and others (2000) 21 reported 40% of patients with visual acuity better than 20/40 at last check up.…”

Section: Visual Outcomementioning

confidence: 89%

Clinical Outcome of Penetrating Keratoplasty in Corneal Opacities of Different Aetiology- A Clinical Study

Bhuyan¹,

Hazarika²,

Neogi³

et al. 2017

jebmh

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BACKGROUND Corneal transplantation or grafting is an operation in which abnormal corneal host tissue is replaced by healthy donor cornea. According to the World Health Organization (WHO), corneal diseases are among the major causes of vision loss and blindness in the world today after cataract and glaucoma. The aim of the study is to-1. Evaluate the different aetiology of corneal opacity including active infective aetiology as indicated for penetrating keratoplasty. 2. Determine the clinical outcome of penetrating keratoplasty in relation to graft survival, graft rejection and peri-operative complications in different aetiology groups. 3. Determine the final visual outcome. MATERIALS AND METHODS Candidates for keratoplasty were selected from-1. Eye Bank of Regional Institute of Ophthalmology (R.I.O). 2. R.I.O OPD. The study period was from September 2014 to August 2015. 30 cases were taken in the study. Descriptive statistics were applied to analyse the data wherever necessary. RESULTS 34.6±19.73 yrs. (mean±SD) was the mean age at which transplants were done in the study. Out of total 30 cases, 13 (43.33%) and 17 (56.66%) were male and female, respectively. The different indications for penetrating keratoplasty are-Post ulcer corneal opacity in 14 cases (46.66%), posttraumatic corneal opacity 9 cases (30%), pseudophakic bullous keratopathy 4 cases (13.33%), corneal dystrophy in 2 cases (6.66%) and non-healing corneal ulcer in 1 case (3.33%). 16 cases (53.33%) showed clear graft till the last follow up while 11 (33.33%) cases showed partially clear graft resulting in improved visual outcome while 3 cases (10.00%) of the grafts were opaque due to graft failure. CONCLUSION The major indications for penetrating keratoplasty in this part of the world are post ulcer and posttraumatic corneal opacity and majority of them are illiterate agricultural workers who failed to get adequate treatment on time. Graft survival rate is high, which can be attributed to the gradual improvement in all the aspects of penetrating keratoplasty, be it the improved viewing system, effective medications to counter complications and better understanding of corneal physiology.

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Corneal Triple Procedure: Indications, Complications, and Outcomes

Abstract: Corneal scarring with cataract is the most common reason for triple procedure in this part of the world. This is a safe surgical procedure with good graft clarity and reasonable visual recovery.

Cited by 19 publications

References 7 publications

Penetrating Keratoplasty in Nepal

Penetrating Keratoplasty in Nepal

The visual and refractive outcomes of combined and sequential penetrating keratoplasty, cataract extraction, and intraocular lens insertion

Clinical Outcome of Penetrating Keratoplasty in Corneal Opacities of Different Aetiology- A Clinical Study

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