LONG-TERM RESULTS OF TRANSSCLERALLY SUTURED POSTERIOR CHAMBER LENSES IN PENETRATING KERATOPLASTY

Purpose. To evaluate the long-term safety and efficacy of transscleral ly sutured posterior chamber lenses in penetrating keratoplasty. Metho ds, This was a retrospective review of 130 patients who underwent pene trating keratoplasty and placement of a transsclerally sutured posteri or chamber lens with at least 1 year of follow-up. The mean follow-up period was 38.8 months. There were 61 patients who had been followed f or at least 3 years (mean, 59 months). Results. At follow-up the visua l acuity was 20/40 or better in 40 patients (31%) and 20/50 to 20/200 in 48 patients (36%). The primary reasons for decreased visual acuity were age-related macular degeneration (18%) and graft failure (13%). N ew-onset glaucoma was found in 19 of 82 patients (23%). In the 48 pati ents who had elevated intraocular pressures preoperatively, the pressu re improved in 13 patients (27%) and worsened in 12 patients (25%). Ex posure of the haptic suture through the conjunctiva occurred in 14 pat ients (11%) at an average of 12 months after surgery. Of these, seven (19%) occurred in patients with conjunctival flaps, and seven (16%) in patients who had scleral flaps covering the haptic suture. No erosion s occurred in the cases in which the suture was rotated inside the eye . Conclusion. Improvements in the surgical technique have made transsc lerally sutured posterior chamber lenses safer in patients with inadeq uate capsular support. The long-term visual results in penetrating ker atoplasty are acceptable and comparable to those of other techniques.