Refractive results after corneal triple procedures (PK+ECCE+IOL)

We have analysed the refractive results of corneal triple procedures (penetrating keratoplasty with extracapsular cataract extraction and posterior chamber intraocular lens implantation) in 52 eyes of 47 patients with a mean follow-up of 39 months. The patients were predominantly old and female and most received unilateral surgery. The contralateral acuity was 6/24 or worse in more than 50% of cases at the time of surgery. Many of these patients were significantly ametropic pre-operatively. Biometry does not seem to have improved the refractive results in those patients in whom it was attempted. The majority of patients were hypermetropic when their refraction stabilised, with resulting poor uncorrected visual performance. Possible improvements are discussed.