Penetrating keratoplasty and transscleral fixation of posterior chamber lens.

We reviewed the charts of 21 patients who underwent penetrating keratoplasty and transscleral fixation of a posterior chamber lens. One lens was sutured in an aphakic eye and 20 lenses were sutured after removal of an anterior chamber lens. Postoperative follow-up averaged 13 months (2-39 months). Visual acuity improved in 20 patients (95%) and remained the same in 1 patient (5%). Postoperative visual acuity was less than 0.1 in 5 patients (23.8%), 0.1 to 0.33 in 14 patients (66.7%) and better than 0.33 in 2 patients (9.5%). Twelve patients (57.1%) expressed a substantial reduction in ocular pain, 7 patients (33.3%) had no pain either before or after the operation, 2 patients (9.5%) expressed no reduction in pain. No cases of endophthalmitis, choroidal hemorrhage or retinal detachment were found. In one case, the sutured lens was dislocated without disturbing vision. Intraocular pressure increased in 3 of 9 patients with preoperative glaucoma. New-onset glaucoma developed in 1 patient. We find transscleral fixation of a posterior chamber lens to be an acceptable procedure in penetrating keratoplasty with IOL implantation where capsular support is inadequate for conventional implantation of a posterior chamber lens.