The effect of standardized keratoplasty technique on IOL power calculation for the triple procedure

Twenty-one consecutive triple procedures (keratoplasty, cataract extraction, lens implantation) performed by one surgeon using identical suturing technique, donor size, and donor/recipient size disparity were analyzed for visual outcome and refractive error. Ninety-five percent of all grafts were clear with an average follow-up of 11.8 months. Of patients with good preoperative visual potential, 84% achieved 20/40 or better visual acuity, and the majority of these patients obtained 20/40 acuity within 6 months of surgery. Sixty-three percent of eyes with 20/40 or better acuity had refractions within +/- 2 diopters of the predicted post-operative refraction. The most recent 14 eyes in this series had IOL power calculations performed utilizing the SRK regression formula and 43.00 K's (surgeon's average post-keratoplasty keratometry values). Within this group, 79% achieved 20/40 or better vision. Eighty-two percent of these eyes had refractions within +/- 2 diopters, and 100% were within +/- 3 diopters of the predicted value. These findings demonstrate that a single surgeon using standardized keratoplasty can achieve good refractive results in the triple procedure.