PHACOEMULSIFICATION AND TRIPLE PROCEDURE

Purpose To evaluate the clinical results of the triple procedure perfo rmed using phacoemulsification. Methods We prospectively studied 23 co nsecutive triple procedures carried out during a 3-year period. The av erage follow-up was 18 months. The main indications for grafting were Fuchs' endothelial dystrophy (30 %) and infectious keratitis (26 %). R esults A capsulorrhexis was performed in 70 % of the cases whereas a < <can opener>> was performed in the remaining 30 %. A divide and conque r phacoemulsification method was used in 43 % of the cases. Hydrodisse ction tvas used for lens removing in 27 % of the cases. The posterior lens capsule was inadvertently broken and a flexible anterior chamber lens was inserted in one case. Twenty-two posterior chamber lenses wer e inserted in the capsular bag (16) or in the sulcus (6). The estimate d 1-year graft survival was 76.8 % overall, and 92,9 % when high-risk recipients were excluded. Causes aft failure were immune rejection (n = 4), persistent epithelial defect (n I) and z b uncontrolled glaucoma (n = 1). The average endothelial density during the second year tvas 1,401 cell/mm(2). Average corrected visual acuity was 20/45 at 12 mont hs. Average astigmatism 1 vas 3.9 D. No retinal complication was obser ved. Conclusions In-the-bag placement of posterior chamber Lens is a s afe and useful technique during the triple procedure. Phacoemulsificat ion may be useful when the nucleus is hard and voluminous.