title: Corneal opacity and cataract: triple procedure versus secondary approach.
abstract: OBJECTIVE
  To determine the efficacy of planned secondary cataract surgery after keratoplasty.
  
  
  METHODS
  Twenty patients (22 eyes) with simultaneous corneal pathology and cataract were enrolled in a prospective, interventional, case-matched, nonrandomized comparative trial. Penetrating keratoplasty (PKP) and extracapsular cataract extraction (ECCE) with IOL insertion (triple procedure) were performed in 11 eyes, and planned phacoemulsification (PEA) with IOL insertion after PKP was performed in 11 case-matched eyes.
  
  
  RESULTS
  There were 10 eyes (91%) within +/-2.0 D of expected values in the secondary PEA group versus 5 patients (45%) in the triple procedure group. No difference was observed in endothelial cell density after 1-year follow-up.
  
  
  CONCLUSIONS
  Planning for secondary PEA in PKP patients with cataracts is a safe and reliable procedure to obtain less post surgical refractive error. Performing a two-stage intervention has no effect on corneal endothelial viability after 1 year.
authors.affiliation: shimmura@tdc.ac.jp
authors.forename: Shigeto
authors.initials: S
authors.lastname: Shimmura
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shiroma
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002386:Cataract / Q000150:complications / Q000628:therapy*; D002452:Cell Count; D003318:Corneal Opacity / Q000150:complications / Q000601:surgery*; D004728:Endothelium, Corneal / Q000166:cytology; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity