Long-term results of transsclerally sutured posterior chamber lenses in penetrating keratoplasty

Abstract

Purpose: To evaluate the long-term safety and efficacy of transsclerally sutured posterior chamber lenses in penetrating keratoplasty.

Methods: This was a retrospective review of 130 patients who underwent penetrating keratoplasty and placement of a transsclerally sutured posterior 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 for at least 3 years (mean, 59 months).

Results: At follow-up the visual 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%). New-onset glaucoma was found in 19 of 82 patients (23%). In the 48 patients who had elevated intraocular pressures preoperatively, the pressure improved in 13 patients (27%) and worsened in 12 patients (25%). Exposure of the haptic suture through the conjunctiva occurred in 14 patients (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 erosions occurred in the cases in which the suture was rotated inside the eye.

Conclusion: Improvements in the surgical technique have made transsclerally sutured posterior chamber lenses safer in patients with inadequate capsular support. The long-term visual results in penetrating keratoplasty are acceptable and comparable to those of other techniques.