Abstract
We have analysed the refractive results of corneal triple procedures (penetrating keratoplasty with extracapsular cataract extraction and posterior chamber intraocular lens implantation) in 52 eyes of 47 patients with a mean follow-up of 39 months. The patients were predominantly old and female and most received unilateral surgery. The contralateral acuity was 6/24 or worse in more than 50% of cases at the time of surgery. Many of these patients were significantly ametropic pre-operatively. Biometry does not seem to have improved the refractive results in those patients in whom it was attempted. The majority of patients were hypermetropic when their refraction stabilised, with resulting poor uncorrected visual performance. Possible improvements are discussed.
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Katzin HM, Meltzer JF . Combined surgery for corneal transplantation and cataract extraction. Am J Ophthalmol 1966; 62:556–60.
Taylor DM . Keratoplasty and intra-ocular lenses. Ophthalmic Surg 1976;7:31–42.
Weisenthal RW, Whitson WE, Krachmer JH . Corneal surgery. In: Tasman W, Jaeger EA, editors. Duane's clinical ophthalmology. Vol. 5. Philadelphia: Lippincott, 1989: 1–46.
Ficker LA, Kirkness CM, Steele ADMcG, Rice NSC, Gilvarry AME . Intraocular surgery following penetrating keratoplasty: the risks and advantages. Eye 1990;4:693–7.
Katz HR, Forster RK . Intraocular lens calculation in combined penetrating keratoplasty, cataract extraction and intraocular lens implantation. Ophthalmology 1985;92:1203–7.
Binder PS . Intraocular lens powers used in the triple procedure: effect on visual acuity and refractive error. Ophthalmology 1985;92:1561–6.
Crawford GJ, Stulting RD, Waring GO, van Meter WS, Wilson LA . The triple procedure: analysis of outcome, refraction, and intraocular lens power calculation. Ophthalmology 1986;93:817–24.
Binder PS . The triple procedure. Refractive results: 1985 update. Ophthalmology 1986;93:1482–8.
Mattax JB, McCulley JR . The effect of a standardized keratoplasty technique on IOL power calculation for the triple procedure. Acta Ophthalmol (Copenh) 1989;67(Suppl 192): 24–9.
Kirkness CM, Cheong PYY, Steele ADMcG . Penetrating keratoplasty and cataract surgery: the advantages of an extracapsular technique combined with posterior chamber intraocular implantation. Eye 1987; 1:557–61.
Geggel HS . Intraocular lens implantation after penetrating keratoplasty: improved unaided visual acuity, astigmatism and safety in patients with combined corneal disease and cataract. Ophthalmology 1990;97:1460–7.
Kirkness CM, Ficker LA, Steele ADMcG, Rice NSC . The success of penetrating keratoplasty for keratoconus. Eye 1990;4:673–88.
Claoué CMP, Falcon MG, Shilling JS . Penetrating keratoplasty in south east London 1981-1986: epidemiological aspects and demands on medical resources. J R Soc Med 1990;83:245–8.
Coster DJ . Some factors which affect the visual outcome of corneal transplantation. Eye 1991;5:265–78.
Pitts JF, Jay JL . The association of Fuchs' corneal endothelial dystrophy with axial hypermetropia, shallow anterior chamber and angle closure glaucoma. Br J Ophthalmol 1990;74:601–4.
Musch DC, Meyer RF, Sugar A, Soong HK . Corneal astigmatism after penetrating keratoplasty: the role of suture technique. Ophthalmology 1989;5:698–703.
Menage MJ, Claoué CMP . Severe herpetic keratitis. II. The cost of penetrating keratoplasty. J R Soc Med 1988;81: 526–7.
Claoué CMP, Falcon MG . Medical manpower requirements following penetrating keratoplasty for herpes simplex keratitis. Acta Ophthalmol (Copenh) 1991;69:105–7.
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Claoué, C., Ficker, L., Kirkness, C. et al. Refractive results after corneal triple procedures (PK+ECCE+IOL). Eye 7, 446–451 (1993). https://doi.org/10.1038/eye.1993.90
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DOI: https://doi.org/10.1038/eye.1993.90