Back to front AC IOL implantation combined with penetrating keratoplasty

In this retrospective study a simple modification of implanting an intraocular lens into the anterior chamber during penetrating keratoplasty is presented. In 14 patients who underwent penetrating keratoplasty after cataract extraction, the intraocular lens was placed back to front in the anterior chamber so that the haptic was angled anteriorly. Postoperative follow-up was 18 months on the average. There was significant improvement in vision. All 9 patients with painful bullous keratopathy were relieved of their pain. One case of mild, transient uveitis and glaucoma and two dilated pupils were seen postoperatively. No major complications have been observed so far. This study suggests that this simple method, in some cases, might be favourable when implanting an intraocular lens during penetrating keratoplasty, in the absence of capsular support.