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To the Editor.
—would like to comment on the recent article by Waring and colleagues.1 There are several difficulties in placing an intraocular lens at the same time a corneal transplant is performed, especially at the same time an offending implant is removed. The new cornea must heal sitting on an eye that is inflamed from the extra manipulation of removing and/or replacing an intraocular lens. I think it is much wiser to perform this procedure in three separate operations. The first removes the intraocular lens, and the eye is allowed to "quiet down" completely before an atraumatic corneal transplant is performed. After the transplant is completely healed, a secondary lens implantation is performed. I will soon be reporting on a series of such cases.The most overwhelming argument for my proposal is the fact that it is extremely difficult, if not impossible, to estimate the postoperative curvature
Hoffer KJ. Triple Procedure for Intraocular Lens Exchange. Arch Ophthalmol. 1987;105(5):609. doi:10.1001/archopht.1987.01060050027004