Frontiers in medicine · 2026
Penetrating keratoplasty combined with intrascleral fixation of a four-haptic intraocular lens in aphakic eyes with corneal pathology.
СтатьяНазвание и аннотация: Перевод в очереди
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Xu Chang, Liao Shuying, Wang Wei, Chen Zhuo, Mao Xiaochun, Li Guigang
Аннотация
PURPOSE: To describe the surgical technique and evaluate the preliminary short-term outcomes of penetrating keratoplasty (PKP) combined with intrascleral fixation of a four-haptic intraocular lens (IOL) in aphakic eyes with corneal pathology and insufficient capsular support.
METHODS: This prospective case series included five consecutive patients who underwent combined PKP and intrascleral fixation of a four-haptic IOL. Four eyes had bullous keratopathy with aphakia, and one had traumatic corneal leukoma with aphakia. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), graft clarity, corneal endothelial cell density (ECD), IOL position, and complications were assessed over at least 6 months.
RESULTS: Mean BCVA improved from 3.00 ± 0.00 logMAR preoperatively to 1.04 ± 0.14 logMAR at 6 months (t = 14.37, p < 0.001). Mean IOP changed from 15.66 ± 1.98 mmHg to 16.48 ± 0.64 mmHg, without significant difference (t = 0.473, p = 0.661). No major intraoperative complications occurred. Four of five grafts remained clear. In the four measurable cases, mean ECD at 6 months was 2,445 ± 193.5 cells/mm2. All IOLs remained centered and stable.
CONCLUSION: Combined PKP and intrascleral fixation of a four-haptic IOL appears to be a feasible single-stage option for selected aphakic eyes with corneal pathology and insufficient capsular support. Favorable short-term anatomical and visual outcomes were observed, but the small sample size, lack of control group, and short follow-up limit generalizability. Larger comparative studies with longer follow-up are needed.
METHODS: This prospective case series included five consecutive patients who underwent combined PKP and intrascleral fixation of a four-haptic IOL. Four eyes had bullous keratopathy with aphakia, and one had traumatic corneal leukoma with aphakia. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), graft clarity, corneal endothelial cell density (ECD), IOL position, and complications were assessed over at least 6 months.
RESULTS: Mean BCVA improved from 3.00 ± 0.00 logMAR preoperatively to 1.04 ± 0.14 logMAR at 6 months (t = 14.37, p < 0.001). Mean IOP changed from 15.66 ± 1.98 mmHg to 16.48 ± 0.64 mmHg, without significant difference (t = 0.473, p = 0.661). No major intraoperative complications occurred. Four of five grafts remained clear. In the four measurable cases, mean ECD at 6 months was 2,445 ± 193.5 cells/mm2. All IOLs remained centered and stable.
CONCLUSION: Combined PKP and intrascleral fixation of a four-haptic IOL appears to be a feasible single-stage option for selected aphakic eyes with corneal pathology and insufficient capsular support. Favorable short-term anatomical and visual outcomes were observed, but the small sample size, lack of control group, and short follow-up limit generalizability. Larger comparative studies with longer follow-up are needed.