Penetrating Keratoplasty Combined With Intrascleral Haptic Fixation Of Iol (Ishf)

To analyse  the functional and anatomical outcome  in cases undergoing penetrating keratoplasty (PK) along with intrascleral haptic  fixation (ISHF) of posterior chamber intra ocular lens  (PCIOL)

Aditya Birla Sankara Nethralaya,Kolkata

Retrospective review of 4 eyes of 4 cases who underwent combined PK with ISHF of PCIOL by the same surgeon over a period of 1 year was recorded. Mean age was 63 (54-76)yrs .3 were females ,and 1 male.Pre-operative and post-operative visual acuity, intra and post-operative complications were analysed.

4 cases underwent combined PK with ISHF of IOL with maximum follow-up period of 2 years .Indications of surgery varied from Pseudophakic bullous keratopathy caused by presence of ACIOL in 2 cases,PCIOL with haptic in anterior chamber in 1 case and Failed Graft status post Therapeutic Penetrating Keratoplasty +Anterior Vitrectomy in 1 case.

Anatomically all eyes had clear graft with good PCIOL stability except one which had haptic exposure and underwent haptic repositioning .Functionally  post surgery visual recovery was limited in 2 cases, due to foveal thinning in 1 case and advanced cupping in another.2 cases had best corrected improvement in visual acuity from 20/2000 to 20/63 in one case and 20/25 in another at 2 yrs follow-up.

The combined procedure of PK with ISHF of PCIOL has been found to be safe and effective procedure in such cases, returning back the corneal dexterity and a better visual rehabilitation.This combined procedure though challenging has favourable outcomes ,for visual rehabilitation in patients with compromised posterior capsule and corneal decompensation