ESCRS - FP31.06 - Cataract Surgery In Eyes With Corneal Graft

Cataract Surgery In Eyes With Corneal Graft

Published 2025 - 43rd Congress of the ESCRS

Reference: FP31.06 | Type: Free paper | DOI: 10.82333/aegr-rx20

Authors: Aulia Kezia Mulyazhara* 1 , Razita Aulia Azkia 1 , Aulia Zinedinita Rahmasari 1 , Intifada Thohari 2

1Faculty of Medicine, Universitas Airlangga,Surabaya,Indonesia, 2Ophthalmology,Faculty of Medicine, Universitas Airlangga,Surabaya,Indonesia;Ophthalmology,Dr. Soetomo General Academic Hospital,Surabaya,Indonesia

Purpose

To evaluate the incidence for cataract development after penetrating keratoplasty (PKP) and the efficacy and safety of cataract removal.

Setting

Bilic Vision Polyclinic, Zagreb, Croatia

Methods

Incidence of and risk factors for cataract formation were analysed among 24 phakic patients who had PKP between 2022 and 2024. Patients were divided into two groups depending on the type of corneal disease: Low-risk Group (n = 12), patients with keratoconus and stromal corneal dystrophy; High-risk Group (n = 12), patients with neovascularized corneal scar and re-grafts. Timing of cataract development was assessed and corelated to postoperative topical steroid usage. Patients with cataract had phacoemulsification (Phaco) and intraocular lens implantation. Endothelial cell density (ECD) loss, best corrected distance visual acuity (BCDVA), spherical equivalence and refractive error were assessed at 1,3,6 and 12 months after cataract surgery.

Results

Cataract formation was noted in 4 (16.6%) of eyes; mean period for cataract formation was 8 months. The incidence of cataract was significantly higher in Group 2 (n =4) than in Group 1 (n =0) (P <0.05), as well as frequency of steroid application. Mean ECD pre-Phaco was 2150 ± 325 cells/mm2. Average Phaco time was 5.34 ± 2.8 sec. All eyes had successful cataract surgery. Graft clarity was 100% and BCDVA was significantly improved. Mean refractive outcome was -0.75 ±1.0 dpt. The decrease in ECD at 12 months was 25.13± 27.8% %, similar to the ECD loss seen in PKP patients without cataract formation.

Conclusions

Cataract formation after PKP is related to diagnosis for which PKP was performed and postoperative steroid regimen. Phacoemulsification in such eyes is safe and effective method providing excellent visual and refractive outcome. Endothelial cell loss is comparable to the post-PKP eyes without cataract formation.