Penetrating keratoplasty and transsclerally suture-fixated intraocular lenses.

BACKGROUND

One of the options the surgeon has, in the absence of lens capsule in an eye to be rendered pseudophakic, is a transsclerally sutured posterior chamber intraocular lens. This procedure can be combined with penetrating keratoplasty, in aphakic or pseudophakic covered edema.

METHODS

We studied retrospectively the results of the first 10 cases of bullous keratopathy in which we performed penetrating keratoplasty combined with transsclerally suture fixated intraocular lenses.

RESULTS

Nine grafts remained transparent and 1 became opaque due to graft rejection with a mean follow up of 26.4 months. Postoperative visual acuity was improved in 7 eyes, remained the same in 2 and became worse in 1 (graft rejection) The poor postoperative visual acuity in 2 eyes was attributed to cystoid macular edema. All sutured intraocular lenses remained in situ; there was no apparent degradation of the Prolene suture. Two eyes developed postoperative medically controlled glaucoma.

CONCLUSIONS

Intraocular lens scleral fixation with sutures, combined with penetrating keratoplasty, seems to be a good procedure for visual rehabilitation for aphakic or pseudophakic bullous keratopathy.