March 2000

The Triple Procedure—Is It the Best Approach for the Patient? Sequential Surgery May Be the Best Approach for the Patient

Author Affiliations



Copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2000

Arch Ophthalmol. 2000;118(3):415-417. doi:10.1001/archopht.118.3.415

THE OCCURRENCE of cataract in the setting of visually significant corneal opacification, such as in Fuchs corneal dystrophy, is not uncommon. In this situation, surgical correction of either single cause of media opacity alone is generally insufficient to visually rehabilitate the patient completely. In 1976, Taylor1 described treatment of these types of patients in which extracapsular cataract extraction (ECCE) and intraocular lens (IOL) insertion were combined with penetrating keratoplasty (PK) as a simultaneous operation, the "triple procedure." Since its description, many surgeons have adopted this approach for the management of simultaneous corneal disease and cataract. While this operation offers convenience in that correction of corneal and lens opacities occur at one sitting, is the simultaneous approach really the best alternative for the patient? What should be the benchmark for deciding the success of the triple procedure? With developments in eye banking and microsurgical techniques for corneal transplantation and astigmatism treatment, the ultimate visual results for combined cataract and corneal transplant procedures should, ideally, approach those resulting from modern cataract surgery.

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