Full-thickness Corneal Transplants with Cataract Surgery still have a Role

Healio
11 Apr, 2019 ,

The corneal triple procedure, either combined or staged, has undergone significant evolution in the past several decades, according to a speaker here. Today, penetrating keratoplasty is no longer used for most corneal replacement surgery because we have better techniques and layer-specific keratoplasty. Instead, we do a DSAEK or DMEK triple, and these procedures are extremely successful. A DMEK triple is the most commonly used procedure in my practice, according to Dr.Sadeer Hannush, MD.

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The corneal triple procedure, either combined or staged, has undergone significant evolution in the past several decades, according to a speaker here.

“Today, penetrating keratoplasty is no longer used for most corneal replacement surgery because we have better techniques and layer-specific keratoplasty. Instead, we do a DSAEK or DMEK triple, and these procedures are extremely successful. A DMEK triple is the most commonly used procedure in my practice,” Sadeer Hannush, MD, said at Cornea360.

Layer-specific keratoplasty, as opposed to penetrating keratoplasty, has given surgeons more options for the visual rehabilitation of patients with surgical cornea disease and cataract. Full-thickness corneal transplants combined with cataract surgery, either staged or combined, still have a role, however, and are indicated in the presence of visually significant and not clinically treatable corneal opacification and cataract, Hannush said.

“Penetrating keratoplasty can still be the procedure of choice for visually significant, medically irreversible corneal pathology affecting all layers of the cornea,” he said. Removing the cataract at the same time as the keratoplasty and the IOL implantation has the advantage of addressing all the pathology in one procedure, but staging the cataract surgery after topographic stabilization of the graft gives the patient the best chance of visual rehabilitation with the least amount of emmetropia, Hannush said. – by Robert Linnehan