Penetrating keratoplasty and transscleral fixation of posterior chamber lens

E. J. Holland, S. M. Daya, A. Evangelista, J. M. Ketcham, A. J. Lubniewski, D. J. Doughman, S. S. Lane

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Abstract

We reviewed the outcome in 115 patients who underwent penetrating keratoplasty and transscleral fixation of a posterior chamber lens. One patient died soon after surgical procedures, and nine patients were lost to follow-up, leaving a cohort of 105 patients. Mean follow-up time was 26.8 months (range, six to 43 months). Visual acuity of 20/40 or better was found in 29 patients (27.6%) and 20/50 to 20/200 in 37 patients (35.2%). Reasons for poor visual outcome included cystoid macular edema in ten patients (9.5%), age-related macular degeneration in six patients (5.7%), and retinal detachment in four patients (3.8%). None of the patients developed lens decentration. There were no instances of hyphema and only one patient had a perioperative limited suprachoroidal hemorrhage. New-onset increase in intraocular pressure developed in 20 of 66 patients (30.3%). Analysis of the 39 patients with preoperative increase in intraocular pressure that required medical treatment demonstrated an improvement in 13 patients (33.3%), worsening in 12 patients (30.8%), and unchanged status in 14 patients (35.9%). The exposed haptic suture was covered by using one of the following three alternative methods: a conjunctival flap, a scleral flap, or a corneal tissue button. Exposure of the haptic suture through the conjunctiva was a complication in 21 patients (20%). Of these, 16 (76.1%) occurred in the group with a conjunctival covering, five (23.8%) occurred in the group with a scleral flap, and none occurred in the corneal tissue button group. This study demonstrated that transscleral fixation of a posterior chamber lens is a viable option in the treatment of patients undergoing penetrating keratoplasty and intraocular lens implantation with absent capsular support.

Original languageEnglish
Pages (from-to)182-187
Number of pages6
JournalAmerican journal of ophthalmology
Volume114
Issue number2
DOIs
StatePublished - Jan 1 1992
Externally publishedYes

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    Holland, E. J., Daya, S. M., Evangelista, A., Ketcham, J. M., Lubniewski, A. J., Doughman, D. J., & Lane, S. S. (1992). Penetrating keratoplasty and transscleral fixation of posterior chamber lens. American journal of ophthalmology, 114(2), 182-187. https://doi.org/10.1016/S0002-9394(14)73982-0