“…Triple surgery involving penetrating keratoplasty (PKP), extracapsular cataract extraction (ECCE), and intraocular lens (IOL) implantation is an effective treatment for patients with corneal pathologies complicated by cataracts. [ 1 – 12 ] Compared with staged surgery, the most important advantages of triple surgery are that it leads to quick improvements in visual acuity, avoids the adverse effects of a second surgery on the donor corneal button, and reduces costs. [ 1 , 3 , 5 , 8 , 13 ] However, traditional triple surgery can involve more risk compared to staged surgery because performing IOL implantation in the open-sky state entails a longer open state duration, which increases the intraoperative risks and difficulty of accurately and safely inserting the IOL into the capsular bag.…”