COMBINED KERATOPLASTY, CATARACT-EXTRACTION, AND INTRAOCULAR-LENS IMPLANTATION AFTER CORNEOLENTICULAR LACERATION IN CHILDREN

Over a period of two years we performed combined penetrating keratopla sty, cataract extraction, and intraocular lens implantation in seven c hildren between the ages of 2 and 12 years old. The interval between t rauma and the surgery varied from six weeks to six months (3.5 +/- 1.6 months, mean +/- SD). All of the patients had undergone primary repai r of corneal perforation. Fresh corneas preserved in McCarey-Kaufman m edium were used. The graft size was 7.5 mm with 0.5 mm disparity. Post erior chamber polymethylmethacrylate C-loop lenses were used in all ca ses. The surgeon's average postkeratoplasty keratometry was used in th e calculation of intraocular lens power. The follow-up period ranged f rom nine to 36 months (18 +/- 9.1 months, mean +/- SD). Six grafts rem ained clear at the final follow-up. The visual acuity ranged from 20/4 0 to 20/200 with final astigmatism ranging from 0.5 diopter to 2.0 dio pters. One patient developed a retinal detachment 12 months after surg ery, which was successfully reattached. One patient, who had preoperat ive corneal vascularization, had graft rejection, which was treated me dically, Our limited series suggests that the triple ocular procedure is a good choice for the treatment of corneolenticular trauma in child ren. The proper postoperative treatment includes vigorous antiamblyopi a therapy and Nd:YAG laser treatment of after-cataracts.