title: Long-term outcome of combined penetrating keratoplasty with scleral-sutured posterior chamber intraocular lens implantation.
abstract: OBJECTIVE
  To evaluate the long-term outcomes of combined penetrating keratoplasty (PKP) with scleral-sutured posterior chamber intraocular lens (PC-IOL) implantation.
  
  
  METHODS
  Medical records from patients with aphakic and pseudophakic bullous keratopathy were retrospectively reviewed for preoperative indications and postoperative results of 105 consecutive patients (105 eyes) who underwent combined PKP and scleral-sutured PC-IOL implantation over a 13-year period. Main outcomes measures were graft survival rate, visual acuity, and intraoperative and postoperative complications.
  
  
  RESULTS
  The principal indications for PKP were pseudophakic and aphakic corneal edema. Graft survival rates were 97% at 1 year, 91% at 2 years, 75% at 5 years, and 68% at 7 years. Mean postoperative follow-up was 44.8 +/- 37.0 months (range 1-156). The best-corrected visual acuity improved at least 1 line on the Snellen chart in 59.0% of the patients, with 42.9% of the eyes achieving acuities of 20/100 or better. Postoperative complications included new glaucoma in 21.4%, worsening of pre-existing glaucoma in 28.6%, cystoid macular edema in 17%, infectious endophthalmitis in 3.8%, and intraocular lens dislocation in 1.9%. No intraoperative complications were encountered.
  
  
  CONCLUSIONS
  PKP combined with scleral-sutured PC-IOL implantation can achieve acceptable outcomes with a low rate of intraocular lens dislocation, but may be associated with significant short and long-term complications.
authors: Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
authors: João Baptista
authors: JB
authors: Malta
authors: Michael
authors: M
authors: Banitt
authors: David C
authors: DC
authors: Musch
authors: Alan
authors: A
authors: Sugar
authors: Shahzad I
authors: SI
authors: Mian
authors: H Kaz
authors: HK
authors: Soong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001036:Aphakia, Postcataract / Q000150:complications / Q000601:surgery; D003316:Corneal Diseases / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007431:Intraoperative Complications; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D011183:Postoperative Complications; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D011126:Polypropylenes