title: Efficacy of chandelier illumination for combined cataract operation and penetrating keratoplasty.
abstract: OBJECTIVE
  The aim of this study was to describe a method for non-open-sky continuous curvilinear capsulorhexis (CCC) with chandelier retroillumination for penetrating keratoplasty triple procedure and report its effectiveness in decreasing intraoperative complications and enabling successful primary intraocular lens (IOL) insertion in patients with moderate or dense central corneal opacities.
  
  
  METHODS
  Seventeen eyes of 17 patients were enrolled in this study, divided into a chandelier group, including 7 eyes of 7 patients, and a nonchandelier group, including 10 eyes of 10 patients. In each group, time to achieve CCC (in seconds), open-sky time (in seconds), and operation time (in minutes) were measured, and the rates of successful CCC completion, rupture of the posterior capsule or zonule of Zinn, and successful IOL insertion were recorded.
  
  
  RESULTS
  CCC time was not significantly different in both groups. In the chandelier group, however, open-sky time and operation time were significantly shorter than in the nonchandelier group (1429 ± 67 vs. 2016 ± 354 seconds, and 90.4 ± 3.5 vs. 108.9 ± 10.3 minutes, respectively). In the chandelier group, the rate of successful CCC completion was significantly higher than in the nonchandelier group (86% vs. 30%). The rates of posterior capsule or zonule of Zinn rupture and successful IOL insertion were not significantly different (14% vs. 40%, 14% vs. 10%, and 86% vs. 70%, respectively).
  
  
  CONCLUSIONS
  Non-open-sky CCC with chandelier illumination has many advantages for penetrating keratoplasty triple procedure compared with open-sky CCC without chandelier illumination.
authors.affiliation: *Department of Ophthalmology, Tohoku Graduate School of Medicine, Sendai, Japan; and †Department of Ophthalmology, Osaka Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Yokokura
authors.forename: Takehiro
authors.initials: T
authors.lastname: Hariya
authors.forename: Megumi
authors.initials: M
authors.lastname: Uematsu
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Meguro
authors.forename: Wataru
authors.initials: W
authors.lastname: Kobayashi
authors.forename: Kohji
authors.initials: K
authors.lastname: Nishida
authors.forename: Toru
authors.initials: T
authors.lastname: Nakazawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019923:Capsulorhexis / Q000379:methods*; D003316:Corneal Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D015948:Keratoplasty, Penetrating / Q000379:methods*; D019654:Lens Implantation, Intraocular / Q000379:methods; D008029:Lighting / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D014792:Visual Acuity