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Topographic and refractive results after triple procedure with closed-globe phacoemulsification before trephination: 24 month follow-up

Poster Details

First Author: L.Mosca ITALY

Co Author(s):    L. Guccione   S. Luceri   M. Gari   M. Toro   R. Secondi   E. Balestrazzi

Abstract Details



Purpose:

To evaluate the topographic and refractive outcomes of corneal triple procedure with closed-globe phacoemulsification before trephination during 24 months follow up.

Setting:

Catholic University of 'Sacro Cuore' of Rome

Methods:

43 eyes of 43 patients (27M, 16F; mean age: 64.8yrs ±13.9SD) underwent triple procedure with phacoemulsification before trephination Indication to surgery was: Corneal decompensation of PK 35.7%, corneal endothelial decompensation 31%, keratoconus 19%, corneal scar 7.2%, stromal dystrophy 7.1%. Preoperative topographic values were average K-readings (Kavg) of 47.7D ± 9.4SD and topographic astigmatism (Top Cyl) of -5.2D ± 3.5SD. Preoperative refractive values were BSCVA as logMAR charts of 0.94 ± 0.35SD; refractive cylinder of -1.3D ± 3.1SD; spherical equivalent (SE) of -0.91D ± 3.85SD. For IOL power calculation mean standard keratometry of 43D was taken. All the surgeries were performed under general anesthesia with a clear cornea phacoemulsification and IOL implantation before corneal trephination. The corneal button diameter was 0,25 mm bigger than the recipient bed and was secured in the recipient bed with four 8/0 nylon cardinal sutures. Then, a double running anti-torque 10+10 bites 10/0 nylon suture was performed. The first suture was removed after a mean period of 12 months, the second after a mean period of 18 months. The final data were obtained six months after all sutures removal.

Results:

Kavg at 1, 6, 12, 24 months follow up was 43.1D ± 2.5SD; 42.8D ± 2.5SD; 42.6D ± 3.7SD 42.9D ± 3.9SD respectively. Top Cyl at 1, 6, 12, 24 months follow up was -6.4D ± 3.7SD; -5.4D ± 5.4SD; -6.1 ± 3.2SD: -5.9D ± 3.4SD respectively. BSCVA as logMAR charts at 1, 6, 12, 24 months follow up was 0.42 ± 0.16SD; 0.3 ± 0.12SD; 0.23D ± 0.15SD and 0.2 ± 0.13SD respectively. Refractive cylinder at 1, 6, 12, 24 months follow up was -0.5D ± 5SD; -1.34D ± 4.7SD; -1.5 ± 4.4SD: -2D ± 3.8SD respectively. Spherical equivalent (SE) at 1, 6, 12, 24 months follow up was -0.35D ± 4.2SD; -0.68D ± 2.9SD; -0.46 ± 2.9SD; -0.53D ± 0.13SD respectively.

Conclusions:

Triple procedure with phacoemulsification before the trephination of the donor cornea is a safe and valid technique in patients with endothelial decompensation and corneal opacities associated to cataract, allowing a shorter visual rehabilitation and reducing the costs and the risks for a second surgery. FINANCIAL INTEREST: NONE

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