title: Novel corneal piggyback technique for consecutive intraocular lens implantation and penetrating keratoplasty surgery.
abstract: OBJECTIVE
  To report a novel "piggyback" penetrating keratoplasty technique performed in a patient with severe keratoconus.
  
  
  METHODS
  A 43-year-old man underwent cataract surgery and a new "piggyback" penetrating keratoplasty (PKP) technique in his right eye, as he suffered from severe keratoconus and mature cataract due to severe atopic dermatitis. Under general anesthesia, phacoemulsification and aspiration (PEA), intraocular lens (IOL) implantation, and "piggyback" PKP while avoiding open-sky surgery was performed to prevent serious complications including IOL and vitreous prolapse. This PKP technique had been completed as a totally closed surgery.
  
  
  RESULTS
  One year after "piggyback" PKP and cataract surgery, the grafted cornea remained clear and IOL was also well positioned. Best-corrected visual acuity improved from hand motions to 30/100.
  
  
  CONCLUSIONS
  A novel "piggyback" PKP technique was successfully performed in a patient with severe keratoconus. The new "piggyback" corneal transplantation technique may become an indispensable tool for transplant surgeons who want to improve surgical safety and predictability.
authors: *Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; and †Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan.
authors: Yukihiro
authors: Y
authors: Matsumoto
authors: Murat
authors: M
authors: Dogru
authors: Jun
authors: J
authors: Shimazaki
authors: Kazuo
authors: K
authors: Tsubota
mesh_terms: D000328:Adult; D002386:Cataract / Q000150:complications; D003315:Cornea / Q000502:physiology; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007640:Keratoconus / Q000150:complications / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000379:methods*; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology