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ALTK with phacoemulsification: managing cataract in the presence of deep corneal opacity – a novel technique

Poster Details

First Author: N.Al Raqqad JORDAN

Co Author(s):    M. Busin   C. Liu                 

Abstract Details


to describe a novel technique that combines automated lamellar keratoplasty ALTK with phacoemulsification for patients with deep corneal opacities.


king Hussein medical center, Jordan


four patients who had cataract and deep corneal opacities were managed at King Hussein Medical Center between June 2016 and January 2018 by performing a combined automated lamellar keratoplasty ALTK with phacoemulsification using topical anesthesia. The choice of corneal button thickness depended on the depth of recipient corneal opacity. Patients who received buttons of 200 µm were secured in place using a contact lens or a bridle suture. Corneal buttons thicker than 200 um were sutured with interrupted sutures that were removed after two months. Modification of phacoemulsification settings were used during surgery.


all patients showed excellent vision postoperatively ranging between 6/9 to 6/18. The procedure took 20-30 minutes and was done under topical anaesthesia. Partial ALTK was performed to create a window for visualization of the cataractous lens and to proceed with phacoemulsification. Replacement of the diseased corneal cap was then done according to the depth of the opacity using the Moria CBM ALTK system.


Combining anterior lamellar keratoplasty with phacoemulsification can shorten operating time, and make for safer phacoemulsification from improving visualization. Our cases show good visual results can be achieved when planned for patients with deep stromal opacities, avoiding major corneal transplantation procedures.

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