The Triple Procedure :Analysis of Structural, Functional & Refractive Outcome

Abstract

PURPOSE:To analyse the outcome of Triple procedure(Combined penetrating keratoplasty, cataract extraction and intraocular lens implantation)  is a surgical technique for visually disabling corneal conditions with associated cataract .METHODS:The medical records  of 120 patients who underwent triple procedure between January 2007 and December 2011 in terms of  demographic data,past ophthalmic history, indications for surgery  were retrospectively reviewed.Salient preoperative data included the initial visual acuity at the time of presentation , slit lamp findings of cornea(scar, haze, vascularisation , stromal folds with bullae ), anterior chamber , lens details , intraocular pressure status ,posterior segment examination with the help of indirect ophthalmoscope or B scan ultrasongraphy.RESULTS:A total of 120 corneal triple procedures performed were included in this study . Of 120 patients , 25 (20.83%)were male and  95 (79.17%)  were female.Mean age of these patients was 42.45 +/-15.85   years(range  9 to 75 years ) . The mean postoperative  follow up was 15.08+/-12.8 months(range ,1.5 to 49 months ).Failed therapeutic grafts(42.5%)-was the  common indication found for surgery .Preoperatively , intraocular pressure was increased in 11(9.16%) patients . Conventional triple procedure in terms of combined penetrating keratoplasty with extracapsular cataract extraction with intraocular lens implantation(PK+ECCE+IOL) was performed in 114 ( 95%) eyes , 01(0.83%)  eye underwent keratoplasty with phacoemulsification with intraocular lens implantation(PK+PE+IOL), and secondary intraocular lens implantation (PK+IOL)in 05 (4.17%)eyes .CONCLUSION:Triple procedure is  an effective surgical option in corneal diseases associated with cataract.It provides an optimal visual and refractive  outcome  especially in high risk grafts situation.