Keratoplasty with primary and secondary lens implantation

Twenty-eight combined grafting and lens implantation operations were performed for patients with corneal disease plus cataract, or aphakia. Eighteen of these cases had cataract extraction at the time of surgery and ten had grafting, vitrectomy and secondary lens implantation in already aphakic eyes. The longest follow-up was forty-seven months; the shortest, six months with an average of 21 months. Complications included cystoid macular edema (five), transient rise in intraocular pressure, hemorrhage. One lens had to be removed, and one graft will have to be replaced with possible removal of the lens. Cystoid macular edema occurred in two cases of the 18 graft-cataract-implant cases (11%) and in three of the 10 cases of graft-vitrectomy-implant patients (30%), a total of 17.9%. Hemorrhage occurred in two cases (7%), and transient elevation of the intraocular pressure also in two cases (7%).