Evaluation of the Results in Intraocular Surgeries Combined with Keratoplasty

Koçluk, Yusuf; Burcu, Ayse; Sukgen, Emine Alyamaç

doi:10.5336/ophthal.2016-51868

Cited by 1 publication

(2 citation statements)

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“… 20 Although CS consisting of cataract extraction and lens implantation together with endothelial keratoplasty provides more predictable refractive outcomes, PK is still indispensable in the presence of stromal scar. 17 , 19 , 33 Some of the patients with endothelial dystrophy in our CS group underwent surgery before we transitioned to endothelial keratoplasty. Some also underwent penetrating surgery because endothelial keratoplasty was not a suitable option due to accompanying stromal opacity.…”

Section: Discussionmentioning

confidence: 99%

“…Advances in lamellar corneal surgeries have led to a reduction in PK surgeries and indications. 18 , 19 , 20 , 21 , 22 , 23 However, PK still has a critical role in chronic bullous keratopathy, full-thickness corneal scars, and medically refractory microbial keratitis, in full-thickness perforations, and in large Descemet’s membrane ruptures during deep anterior lamellar keratoplasty. 3 , 4 , 18 , 19 , 20 , 21 , 22 , 23 The visual and refractive outcomes of cataract surgery when combined or performed sequentially with PK and the effects of these procedures on graft survival are still controversial today.…”

Section: Introductionmentioning

confidence: 99%

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Corneal Pathology and Cataract: Combined Surgery or Sequential Surgery?

Uzman¹,

Akkaya²,

Düzova³

et al. 2021

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Objectives: To compare our combined surgery (CS) and sequential surgery (SS) results. Materials and Methods: The files of 44 patients who underwent CS (penetrating keratoplasty [PK], cataract extraction, and intraocular lens [IOL] implantation) and 126 patients who underwent SS (cataract extraction and IOL implantation in a second session after PK) between January 2009 and December 2018 were evaluated retrospectively. One eye of the patients who were followed up for at least 1 year was included in the study. The two groups were compared in terms of indications, corrected distance visual acuity (CDVA), refractive results, complications, and graft survival. Results: In the CS and SS groups, the median age was 63 (30-79) and 43 (18-73) years (p<0.001) and the median follow-up time was 51 (13-152) and 64.5 (13-154) months (p=0.011), respectively. The most common PK indications were traumatic corneal scar (20.5%) and endothelial dystrophy (15.9%) in the CS group versus keratoconus (24.6%) and stroma dystrophy (17.5%) in the SS group. In the CS and SS groups, 50% vs 69% of patients had CDVA ≥0.4 (p=0.04); 45.5% vs 25.4% had CDVA (0.1-0.3) (p=0.04); and 54.5% vs 73% had spherical equivalent ≤±2.0 D (p=0.02). The most common postoperative complications were glaucoma (20.5% vs 15.9%, p=0.48) and allograft reaction (9.1% vs 23%, p=0.04). Graft survival rates were 95.2% vs 86.5% (p=0.10) at 1 year and 75.9% vs 68.9% (p=0.47) at 5 years, respectively. Conclusion: Over long-term follow-up, the groups were similar in terms of graft survival. For this reason, each patient must be evaluated separately whether to perform a combined or sequential surgery. Given the lower refractive error and higher expectation of final visual acuity, SS can be more advantageous especially in young patients.

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