Surgical results of concomitantly performed optical PKP with glued scleral fixated IOL
First Author: R.Agarwal INDIA
Co Author(s): S. Yadav C. Chetan N. Sharma
To describe surgical results of concomitantly performed optical penetrating keratoplasty (PKP) with glued scleral fixated intraocular lens (SF-IOL)
Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi
A retrospective review of 18 patients, belonging to age-group 15-72years with unilateral corneal opacity and aphakia subjected to concomitant optical PKP with glued SF-IOL during May 2017 to May 2019 and followed-up for a mean time of 11.61months (3-24months) was undertaken to evaluate its anatomical and visual results. Baseline best-corrected visual acuity (BCVA) was ≤1/60 in all patients. The most common diagnoses were failed PKP (9), surgical (3) and post-traumatic (2) aphakic bullous keratopathy, post-traumatic anteriorly dislocated lens (1), pseudophakic bullous keratopathy (1), healed keratitis (1) and phakic IOL associated decompensation (1).
Pre-operative glaucoma, iris abnormalities and deep vascularization was present in 7/18 (38.88%), 12/18 (61.11%) and 5/18 (27.77%) patients. The mean postoperative astigmatism was 8.94±1.85 (7.5-13)D. Post-operative complications were seen in 13/18 patients (72.22%) which included glaucoma (11/18) followed by rejection (3/18) and retinal detachment (1/18). The average time of appearance of complication was 4.9months (0.5-12months) after surgery and graft failure was noted in 10/18 cases (55.55%). In 16/18 patients, improvement in BCVA was noted, while two patients reported deterioration of BCVA after surgery. However, in five out of these 16 patients, BCVA deteriorated due to complications at their last follow-up.
Concomitant performed optical PKP with glued SFIOL carries high rate of postoperative complications and graft failure. These have to be thoroughly discussed with patients before undertaking the surgery.