Long-term outcome of combined penetrating keratoplasty with scleral-sutured posterior chamber intraocular lens implantation.
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.
Malta
João Baptista
JB
Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
Banitt
Michael
M
Musch
David C
DC
Sugar
Alan
A
Mian
Shahzad I
SI
Soong
H Kaz
HK
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
D011126:Polypropylenes