Long-term outcomes of combined penetrating keratoplasty with iris-sutured intraocular lens implantation.
OBJECTIVE
To evaluate the long-term outcomes of combined penetrating keratoplasty with iris-sutured posterior chamber intraocular lens implantation.


METHODS
Patients (264 eyes) with aphakic and pseudophakic bullous keratopathy.


METHODS
Retrospective case series.


METHODS
Penetrating keratoplasty combined with implantation of an iris-sutured posterior chamber intraocular lens performed by a single surgeon.


METHODS
Data were gathered from the institutional database during a period of 10 years (1989-1999) and analyzed using customized software.


METHODS
Graft survival rate, visual acuity, and intraoperative and postoperative complications.


RESULTS
Two-hundred fifty-two consecutive patients (264 eyes) were operated. Graft survival rates were 95% at 1 year, 89% at 2 years, and 81% at 5 years and were comparable to the results of previous corneal transplant studies. Among 180 patients (191 eyes) with a follow-up of at least 2 years (range, 2-11 years; mean, 5 years), the visual acuity at final follow-up visit, compared with preoperative visual acuity was improved in 72% of eyes (mean preoperative visual acuity, 20/250; mean postoperative visual acuity, 20/60). No intraoperative complications were encountered.


CONCLUSIONS
Combined penetrating keratoplasty with iris-sutured posterior chamber intraocular lens implantation offers significant vision benefits in this patient group.
The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Esen Karamursel
EK
Akpek
Rana
R
Altan-Yaycioglu
Koray
K
Karadayi
William
W
Christen
Walter J
WJ
Stark
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001036:Aphakia, Postcataract / Q000601:surgery*; D015715:Corneal Edema / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007431:Intraoperative Complications; D007498:Iris / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000379:methods*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity