CLINICAL SCIENCESCorneal Opacity and Cataract: Triple Procedure Versus Secondary ApproachShimmura, Shigeto M.D.; Ohashi, Yoshie M.D.; Shiroma, Hiroki M.D.; Shimazaki, Jun M.D.; Tsubota, Kazuo M.D.Author Information Submitted October 1, 2002. Revision received January 7, 2003. Accepted January 7, 2003. Address correspondence and reprint requests to Shigeto Shimmura, M.D., Department of Ophthalmology, Tokyo Dental School, 5-11-13 Sugano, Ichikawa 272-8513, Japan. E-mail: [email protected] Cornea: April 2003 - Volume 22 - Issue 3 - p 234-238 Buy Abstract Purpose. To determine the efficacy of planned secondary cataract surgery after keratoplasty. Methods. Twenty patients (22 eyes) with simultaneous corneal pathology and cataract were enrolled in a prospective, interventional, case-matched, nonrandomized comparative trial. Penetrating keratoplasty (PKP) and extracapsular cataract extraction (ECCE) with IOL insertion (triple procedure) were performed in 11 eyes, and planned phacoemulsification (PEA) with IOL insertion after PKP was performed in 11 case-matched eyes. Results. There were 10 eyes (91%) within ±2.0 D of expected values in the secondary PEA group versus 5 patients (45%) in the triple procedure group. No difference was observed in endothelial cell density after 1-year follow-up. Conclusions. Planning for secondary PEA in PKP patients with cataracts is a safe and reliable procedure to obtain less post surgical refractive error. Performing a two-stage intervention has no effect on corneal endothelial viability after 1 year. © 2003 Lippincott Williams & Wilkins, Inc.