Corneal triple procedure: indications, complications, and outcomes: a developing country scenario.
OBJECTIVE
We report the indications, complications, and outcomes of 104 corneal triple procedures in our institute.


METHODS
Patient records of 104 consecutive cases of corneal triple procedure (penetrating keratoplasty with extracapsular cataract extraction and intraocular lens implantation) performed by experienced corneal surgeons between January 1992 and December 1997 were retrospectively reviewed. Relevant preoperative, operative, and postoperative data were collected. The outcome was assessed by the graft clarity and visual acuity at the last visit. Survival analysis of these grafts was determined by Kaplan-Meier method.


RESULTS
Of 104 patients, 70 were men and 34 were women. Mean age of these patients was 48.5+/-17.1 years (range, 1-75 years). Corneal scarring with cataract was the reason for surgery in 69 (66.4%) cases. The intraoperative complications included vitreous upthrust in seven (6.9%) cases and posterior capsular dehiscence in three (2.9%) cases. The most common early postoperative complications were increased intraocular pressure in 19 (18.3%) and increased anterior chamber reaction in 25 (24%) cases. Posterior capsular opacification was seen in 26 (25%), graft reaction in 15 (14.4%), and secondary glaucoma in 15 (14.4%) cases. These formed the important late postoperative complications. The average postoperative follow-up was 23.7+/-17.6 months (range, 1.6-79.4 months); at which time 72% of the grafts remained clear. At last follow-up, 40% of patients had a visual acuity of > or = 20/40.


CONCLUSIONS
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.
Sridhar
M S
MS
Cornea Centre, L.V. Prasad Eye Institute, Hyderabad, India. mss@lvpeye.stph.net
Murthy
S
S
Bansal
A K
AK
Rao
G N
GN
D000293:Adolescent; D000328:Adult; D000368:Aged; D002386:Cataract / Q000150:complications*; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000150:complications* / Q000601:surgery; D003906:Developing Countries; D005260:Female; D006085:Graft Survival; D006801:Humans; D007194:India; D007223:Infant; D007431:Intraoperative Complications; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity