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Cataract surgery with endothelial keratoplasty.

Muhammad A Ahad1, Sara M AlHilali, Deema E Jomar

  • 1Cornea, External Eye Diseases and Refractive Surgery Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

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Combining cataract surgery with endothelial keratoplasty (EK) is effective for corneal diseases. Careful planning, IOL selection, and surgical technique optimize outcomes, with patient factors guiding sequential versus triple EK choices.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Cataract Surgery

Background:

  • Corneal endothelial diseases often coexist with cataracts, necessitating combined surgical approaches.
  • Advances in diagnostics and surgical techniques have refined combined cataract surgery and endothelial keratoplasty (EK).

Purpose of the Study:

  • To summarize the combined approach of cataract surgery with EK.
  • To address key considerations including IOL choice, sequential vs. triple EK decisions, surgical techniques, and postoperative management.

Main Methods:

  • Review of recent literature on combined cataract surgery and EK.
  • Analysis of imaging techniques for detecting corneal edema.
  • Comparison of sequential and triple EK outcomes and complications.

Main Results:

  • Advanced imaging aids in surgical decision-making for EK.
  • Sequential and triple EK yield similar visual outcomes; triple EK offers faster recovery but may have higher complication rates.
  • Hyperopic refractive surprises are common; avoid hydrophilic IOLs due to opacification risk.

Conclusions:

  • Combined cataract surgery and EK is an effective treatment for concurrent corneal endothelial disease and cataract.
  • Preoperative evaluation, IOL selection, and surgical technique are vital for optimal results.
  • Patient-specific factors should guide the choice between sequential and triple EK procedures.