Triple Procedure—Method of Choice for Cataractous Eyes with Corneal Pathology

Abstract

Objectives: Combined method of surgery — ‘triple procedure’ (extracapsular cataract extraction, posterior chamber lens implantation and partial perforative keratoplasty) was used to restore visual functions of cataractous eyes with coincident corneal pathology. Additional surgeries (synechiolysis, trabeculectomy, pupiloplasty) were done in complicated cases. Patients: Postoperative results in 32 cataractous eyes of 31 patients (1 binocular case) having different kinds of corneal pathology were prospectively analysed. Main Outcome Measures: Complication rate, best corrected postoperative visual acuity after 3/6 months follow-up period. Results: Posterior capsular fibrosis (14%) cystoid macular oedema (7%), graft rejection (6%) and other complications (9%) were late complications. Postoperative visual acuity ≥ 0.4 was achieved in 51% after 3, and in 81% of patients after 6 months of postoperative follow-up. Strong corneal vascularization in 2 eyes compromised the graft, indicating rekeratoplasty. Conclusion: We find ‘triple procedure’ to be the method of choice for treatment of cataractous eye with associated corneal pathology. Additional surgeries (synechiolysis, trabeculectomy, pupiloplasty) help to solve complicated cases.