VIDEOKERATOSCOPY OF RECIPIENT PERIPHERAL CORNEAS IN COMBINED PENETRATING KERATOPLASTY, CATARACT-EXTRACTION, AND LENS IMPLANTATION

PURPOSE: We performed a prospective clinical trial to evaluate compute rized videokeratoscopic analysis of the peripheral recipient cornea in intraocular lens power calculations for triple procedures: penetratin g keratoplasty, cataract extraction, and intraocular lens insertion. M ETHODS: Patients with Fuchs' dystrophy underwent consecutive triple pr ocedures, Surgery was performed in 16 eyes by a single surgeon (O.N.S. ) using a single technique, If videokeratoscopic analysis disclosed di optric powers greater than 40 diopters in the circumference of the cor neal map, the surgeon's average postoperative central corneal power of 46 diopters was used with the regression formula, If dioptric powers less than 40 diopters were detected in the circumference of the cornea l map, 45 diopters was used to avoid postoperative hyperopic shifts an d to decrease deviation from intended refractive error, Refraction and videokeratoscopic analysis were performed six months after suture rem oval (18 to 24 months postoperatively). RESULTS: Analysis of covarianc e demonstrated that preoperative peripheral videokeratoscopic data of the recipient cornea correlated (P = .0001) with postoperative central corneal power, whereas preoperative central corneal power of the reci pient cornea did not correlate (P = .35), Deviation from intended refr action (range, -2.54 to +1.22 diopters) was within 2 diopters in 14 ey es (88%) and within 3 diopters in all eyes, No patients had anisometro pia greater than 3 diopters. CONCLUSION: Preoperative data from comput erized videokeratoscopic analysis of the recipient peripheral cornea c orrelated with postoperative central corneal power, and improved posto perative refractive outcomes compared with previously reported results of triple procedures.