Iris-sutured posterior chamber intraocular lens implantation during penetrating keratoplasty*1

Abstract

This retrospective study examined the indications and postoperative results of 342 consecutive patients (366 eyes) who underwent iris suturing of a posterior chamber intraocular lens implant during penetrating keratoplasty during a 9 year period. The principle indication was pseudophakic or aphakic bullous keratopathy (301 eyes), followed by failed graft (48 eyes), Fuchs dystrophy (22 eyes), and other (10 eyes). The mean age at the time of surgery was 75 years (median 76, standard deviation 8.64, range 39–97 years). The mean follow up was 37.7 months (median 33, standard deviation 25.4, range < 6–102 months). The mean best corrected visual acuity improved from 20/474 preoperatively to 20/85 at 1 year (P < .0001). Best corrected visual acuity improved in 74.9% of eyes, remained the same in 10.4%, and worsened in 14.7%. Seventy-two (29%) eyes without preoperative glaucoma required treatment of elevated intraocular pressure. Nine (7.7%) eyes with known preoperative glaucoma required escalation of therapy by medication or surgery. Seventy-nine (28%) eyes without known preoperative cystoid macular edema were additionally diagnosed. Corneal rejection episodes occurred in 36 (9.8%) eyes, with the majority having a single episode. Overall, 27 (7.4%) eyes had known graft failure at last follow-up. Two eyes (0.5%) were enucleated following wound disruption.