Penetrating keratoplasty with anterior or posterior chamber intraocular lens implantation

I. Brunette, R. D. Stulting, J. R. Rinne, G. O. Waring 3rd and M. Gemmil
Emory Eye Center, Emory University School of Medicine, Atlanta, Ga.

OBJECTIVE: To compare the outcome of anterior chamber (AC) intraocular lens (IOL) implantation with the outcome of posterior chamber (PC) IOL implantation at the time of penetrating keratoplasty in the absence of capsular support. DESIGN: Retrospective study of 122 eyes that underwent secondary IOL implantation without capsular support at the time of penetrating keratoplasty. Ninety eyes received an AC IOL and 32 received a PC IOL sutured to the iris or the ciliary sulcus. RESULTS: Survival analysis showed the probability of a clear graft to be 86% for eyes with an AC IOL and 90% for eyes with a PC IOL at 1 year. Intraocular pressure rose by 5 mm Hg or more in 30% of eyes with AC IOLs and 5% of eyes with PC IOLs. Visual acuity was better than 20/200 in 48% of eyes with AC IOLs and 68% of eyes with PC IOLs. CONCLUSION: This study demonstrated a trend for a better outcome with PC IOLs than AC IOLs for secondary implantation at time of penetrating keratoplasty in the absence of capsular support.