Combined surgery with deep lamellar keratoplasty

The opportunity to perform two or more ophthalmic operations simultaneously has increased in recent years. In keratoplasty too, the simultaneous operation consisting of cataract extraction and IOL insertion (triple procedure) has become common. Penetrating keratoplasty (PKP) and planned extracapsular cataract extraction (PECCE) or vitrectomy is today often done simultaneously. However, phacoemulsification and aspiration (PEA) or 3 ports vitrectomy has to be performed on patients with corneal opacity due to some corneal diseases. In such cases, we performed the PEA or vitrectomy coupled with deep lamellar keratoplasty (DLK), successfully applied to closed eye surgery with corneal opacity. Simultaneous surgery using DLK, free of postoperative endothelial type of rejection, and PEA, enabling cataract extraction by a small incision, is a surgical technique making use of the advantage of the two types of operation. We performed the DLK + PEA + IOL on 17 cases. In the other hand, simultaneous surgery consisting of DLK and vitrectomy may be taken into consideration. The use of DLK will make it possible to perform surgery on urgent vitreoretinal diseases with corneal opacity and cataract. We performed the DLK + 3 ports vitrectomy on 3 cases. The current study describes the advantages and disadvantages of these types of operation.