The Triple Procedure: Analysis of Outcome, Refraction, and Intraocular Lens Power Calculation

Geoffrey J. Crawford, R. Doyle Stulting, George O. Waring, Woodford S. Van Meter, Louis A. Wilson

Research output: Contribution to journalArticlepeer-review

76 Scopus citations

Abstract

Presented are the results of 66 consecutive, elective, combined procedures of penetrating keratoplasty, extracapsular cataract extraction, and intraocular lens insertion (triple procedure) performed by three surgeons between January 1981 and January 1984. After a mean postoperative followup of 15.8 months, over 90% of the eyes had clear grafts, and of the 56 eyes with good preoperative visual potential, 77% achieved a best corrected visual acuity of 20/40 or better. The postoperative mean refractive deviation from emmetropia was 2.17 diopters, with a range of +6.62 D to −5.50 D, 62% falling between −2.00 and +2.00 diopters. Using multiple regression analysis of preoperative and postoperative variables, an attempt was made to derive a predictive formula for the power of the intraocular lens to be implanted during the triple procedure. In contrast to cataract surgery, where axial length and corneal power remain fairly constant preoperatively and postoperatively, penetrating keratoplasty produces marked changes in corneal curvature and power. Therefore, a single formula could not be derived to predict accurately the intraocular lens power for the patients. However, using the results for an individual surgeon, a formula was derived that could improve the predictability of intraocular lens power.

Original languageEnglish
Pages (from-to)817-824
Number of pages8
JournalOphthalmology
Volume93
Issue number6
DOIs
StatePublished - 1986

Bibliographical note

Funding Information:
Supported in part by P. F. Sobotka Postgraduate Fellowship, University of Western Australia (Crawford), and an unrestricted grant from Research to Prevent Blindness, Inc.

Funding

Supported in part by P. F. Sobotka Postgraduate Fellowship, University of Western Australia (Crawford), and an unrestricted grant from Research to Prevent Blindness, Inc.

FundersFunder number
Research to Prevent Blindness
University of Western Australia

    Keywords

    • combined procedure
    • extracapsular cataract extraction
    • intraocular lens implantation
    • linear regression
    • multiple regression analysis
    • penetrating keratoplasty
    • triple procedure

    ASJC Scopus subject areas

    • Ophthalmology

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