Cataract Extraction Following Penetrating Keratoplasty

Abstract

Abstract: : Purpose: To evaluate visual acuity, corneal graft clarity and refractive error following cataract extraction in eyes with previous history of penetrating keratoplasty. Methods: Retrospective chart review of patients seen on the Cornea Service at Wills Eye Hospital, with a history of penetrating keratoplasty, who underwent cataract extraction and intraocular lens implantation from June 1, 1992 to July 31, 2002. Results: Thirty-two eyes of 27 patients were identified, including 16 females and 11 males with a mean age of 66.8 years at the time of surgery. Mean time from penetrating keratoplasty to cataract surgery was 104.3 months. Pre-operative visual acuity was 20/40-20/100 in 6 eyes, 20/200-20/400 in 21 eyes, counting fingers in 5 eyes and hand motion in 2 patients. Pre-operative spectacle correction was documented in 24 eyes with a mean spherical power of 6.55 diopters and mean cylindrical power of 3.21 diopters. Pre-operative endothelial cell counts were documented in 17 eyes, with a mean of 1100. Mean follow-up time following cataract extraction was 45.6 months. Post-operative visual acuity was 20/20-20/40 in 24 eyes, and 20/50-20/70 in 8 eyes. Post-operative spectacle correction was documented in 21 eyes, with a mean spherical power of 3.05 diopters and mean cylindrical power of 3.01 diopters. There were no documented episodes of corneal graft rejection or failure in any of the eyes. Conclusions: Cataract surgery can be successfully performed in patients with corneal grafts. Following cataract surgery, patients with corneal grafts may benefit from decreased spherical refractive error and improved visual acuity.

Keywords: cornea: clinical science • cataract • cornea: endothelium