Surgical management of coexisting corneal and lens opacities: one-stage vs two-stage approach

PurposeThe aim was to compare the refractive and visual outcome of the triple procedureand the sequential surgery and to report any adverse effects or complications ofeach approach.Patients and methodsForty eyes of 40 patients with corneal opacity and visually significant cataract weredivided into two equal groups: the triple group (group I) and the sequential group < br />(group II). In group I, patients underwent PKP with cataract extraction by eitheropen sky ECCE technique or phacoemulsification according to the degree ofcorneal clarity. In group II, patients first underwent PKP then scheduled forphacoemulsification and intraocular lens implantation. All patients were followedup for 1 year, and data including the visual acuity, refractive outcome, ECC andcomplications were recorded and analyzed.Pkp penetrating keratoplasty ECCE extracapsular catarct extractionResultsAfter 1 year of follow-up, the mean best corrected visual acuity (BSCVA) was 0.35±0.13, with 45%of eyes with BSCVA greater than or equal to 0.5 in group I. In group < br />II, the mean BSCVA was 0.52±0.12 (P=0.021), with 60% of eyes with BSCVAgreater than or equal to 0.5(P=0.14). Mean spherical equivalent after tripleprocedure was −1.6±0.2 D. Mean spherical equivalent following sequentialsurgery was −0.29±0.24D (P=0.00). The mean cylinder after combined surgerywas −3.85±1.21, compared with −3.45±0.82D after sequential surgery (P=0.231).Overall, 50%of group I and 70.0% of group II patients were within ±2D of the targetrefraction (P=0.19). No significant difference in the mean ECC was found at the endof follow-up period (P=0.524).ConclusionPlanned phacoemulsification after PKP is a safe and effective approach formanagement of coexisting lens and corneal opacity