Triple Procedure: A Stepwise Combination of Deep Anterior Lamellar Keratoplasty and Cataract Surgery

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dc.contributor.authorAlfonso Bartolozzi, Belén
dc.contributor.authorFernández Vega Cueto, Luis
dc.contributor.authorFernández-Vega, Luis
dc.contributor.authorMartínez Alberquilla, Irene
dc.contributor.authorMadrid Costa, David
dc.contributor.authorAlfonso, José F.
dc.date.accessioned2024-01-11T11:29:41Z
dc.date.available2024-01-11T11:29:41Z
dc.date.issued2023-08-18
dc.description.abstractPurpose: The aim of this study was to evaluate clinical outcomes of the combined surgery (triple procedure) of deep anterior lamellar keratoplasty (DALK), phacoemulsification, and intraocular lens (IOL) implantation using a new surgical strategy. Methods: The study included 43 eyes of 43 patients who underwent a triple procedure. Twenty-six eyes with good visibility through the cornea underwent phacoemulsification before the stromal dissection. Seventeen eyes with bad visibility underwent the DALK procedure first until achieving enough visibility to perform the lensectomy. IOL power calculation was performed for a postoperative estimated flat keratometry of 43.5 and aiming to avoid hyperopic postoperative refraction. The postoperative visual examination included uncorrected and corrected distance visual acuity (CDVA) measurements and manifest refraction. Results: The mean follow-up time after suture removal was 3.06 ± 2.14 years. Mean CDVA significantly changed from 0.86 ± 0.56 logMAR preoperatively to 0.37 ± 0.28 logMAR in the last visit (P < 0.0001). The percentage of eyes with CDVA ≤0.3 logMAR changed from 6.9% preoperatively to 62.8%. No eyes lost lines of vision after surgery, and 80% experienced an improvement of 2 or more lines. The safety index was 2.2. The mean postoperative refractive sphere was +0.13 ± 2.04 D, and the postoperative refractive cylinder was -4.02 ± 2.24 D. Only 2 cases (4.65%) obtained postoperative hyperopic astigmatism. No intraoperative complications were found. Conclusions: Combined surgery of DALK, phacoemulsification, and IOL implantation is an effective and safe procedure. Depending on the corneal transparency, different surgical strategies can be established to provide more efficacy and safety.
dc.description.departmentDepto. de Optometría y Visión
dc.description.facultyFac. de Óptica y Optometría
dc.description.refereedTRUE
dc.description.statusinpress
dc.identifier.doi10.1097/ICO.0000000000003364
dc.identifier.essn1536-4798
dc.identifier.issn0277-3740
dc.identifier.officialurlhttps://doi.org/10.1097/ico.0000000000003364
dc.identifier.relatedurlhttps://journals.lww.com/corneajrnl/fulltext/9900/triple_procedure__a_stepwise_combination_of_deep.348.aspx
dc.identifier.urihttps://hdl.handle.net/20.500.14352/92502
dc.journal.titleCórnea
dc.language.isoeng
dc.publisherWolters Kluwer
dc.rightsAttribution 4.0 Internationalen
dc.rights.accessRightsrestricted access
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subject.cdu617.7
dc.subject.keywordtriple procedure; DALK; cataract surgery
dc.subject.ucmÓptica y optometría
dc.subject.unesco2209.15 Optometría
dc.titleTriple Procedure: A Stepwise Combination of Deep Anterior Lamellar Keratoplasty and Cataract Surgery
dc.typejournal article
dc.type.hasVersionVoR
dspace.entity.typePublication
relation.isAuthorOfPublication7d72044d-983a-4b5a-abab-6a5e45396824
relation.isAuthorOfPublication383ca857-3af5-4787-8717-d278082d1d13
relation.isAuthorOfPublication.latestForDiscovery7d72044d-983a-4b5a-abab-6a5e45396824
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