To compare the refractive and visual outcomes of combined penetrating keratoplasty
and cataract surgery
(triple procedure) with those of sequential surgery
followed by secondary cataract extraction and posterior chamber intraocular lens implantation).
Forty-six consecutive patients undergoing triple procedure or sequential surgery
performed by two surgeons were reviewed retrospectively. The triple procedure group consisted of 23 patients and the sequential surgery
group also consisted of 23 patients. Refractive and visual outcomes were collected and analyzed with at least 1 year of follow-up for both groups. Both the difference from target and the variability of the refractive outcome
Best spectacle corrected visual acuity of 6/12 or better was achieved in 16 eyes (69.8%) in the triple procedure group and in 19 eyes (82.6%) in the sequential surgery
group. For both the triple and sequential groups, there was no difference between the mean postoperative refractive outcome
(−2.73/+1.05 × 109 SD = 4.30/1.42/4.43) and (−1.33/+0.79 × 175 SD = 2.39/1.16/2.33) compared with the mean target refraction
(−0.77, SD = 1.16 and −0.43, SD = 0.99), (p = 0.39 and 0.48), respectively. In addition, there was no significant difference in the variability of the refractive outcome
between the two groups (p > 0.99).
Conclusions. Sequential surgery
appears to offer no significant advantages over the triple procedure in terms of refractive predictability or variability. There was a slight trend toward more patients achieving 6/12 or better vision in the sequential group.