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First Author: V.Naumenko RUSSIA
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To evaluate clinical results of the new combined surgery included penetrating keratoplasty, non-penetrating glaucoma surgery and cataract extraction with IOL implantation.
Academician S.N. Fedorov St.Petersburg Branch of the IR&TC "Eye microsurgery", St.Petersburg, Russia.
21 patients with leucoma, cataract and open-angle glaucoma were treated by combined one-stage surgery. BCVA before operation was 0,02ḟ0,03. IOP before operation was 29,8ḟ3,1 mmHg. Fresh corneas with endothelial density more then 2000 cells per sq.mm. were used in all cases. One-stage surgery technique: 1. 3/4 corneal thickness trepanation 2. Conjunctiva is separated toward limbus. Superficial scleral flap 5*5 mm is formed 3. 5 intrascleral ditches are performed 4. Deep scleral flap 1*4 mm with trabecula is removed. Superficial scleral flap is sutured 5. Anterior synechiae are dissected. 6. Leucoma is removed 7. Extracapsular cataract extraction 8. Posterior chamber IOL implantation 9. Corneal transplant is sutured 10. Conjunctiva is sutured.
Biological results 1 year after surgery: transparent engraftment 72,6%, transparent failure 27,4%. BCVA 0,19ḟ0,26, corneal astigmatism 4,3ḟ1,25. 3 year after surgery: transparent engraftment 56,8%, BCVA 0,17ḟ0,08, corneal astigmatism was 2,5ḟ1,18D
Biological and functional results in patients with leucoma, open-angle glaucoma and cataract treated by the proposed technique demonstrates that the combined one-stage surgery consisted of penetrating keratoplasty, non-penetrating glaucoma surgery and cataract extraction is safe and efficient technique.