Combined Kelman procedure (phaco-emulsification cataract extraction) and simultaneous aphakic penetrating keratoplasty.

The problem of management of coexistent lenticular and corneal opacification is, as yet, unresolved. Combined intracapsular cataract extraction and penetrating keratoplasty affords the risk of vitreous loss at the time of surgery or perhaps the even greater risk of vitreous adhesion to the donor cornea. Leaving an intact posterior capsule would certainly avoid the problems of vitreous touch. Where applicable, we have been utilizing the technique of combined phaco-emulsification cataract extraction followed by aphakic penetrating keratoplasty leaving an intact posterior capsule and removing all cortical remnants with the irrigation-aspiration probe of the Kelman Cavitron unit. This technique has proved extremely useful in our hands and we suggest that it is a useful alternative in the management of coexistent lenticular and corneal opacification.