Modifying the position of cataract incisions in triple procedure.

PURPOSE: The authors present a surgical technique for enhancing the visualization of the lens capsule by lamellar corneal dissection and performing phacoemulsification through the partially trephined recipient bed in eyes undergoing penetrating keratoplasty combined with cataract surgery. METHODS: First, the cornea was thinned by lamellar dissection in 11 patients undergoing triple procedure (penetrating keratoplasty, phacoemulsification, and intraocular lens implantation). After continuous curvilinear capsulorhexis (CCC) was performed in the closed system, phacoemulsification was carried out through the incisions that were created on the partially trephined recipient bed. The trephination was completed by excising the remaining corneal tissue and intraocular lens was implanted. At the end of the surgery, donor cornea was sutured into the recipient bed. RESULTS: The cataract surgery was performed in a closed system and the cataract incision places were removed at the end of the surgery; therefore both CCC and phacoemulsification could be completed easily without any intraoperative complication in 11 eyes of 11 patients. CONCLUSIONS: Phacoemulsification, through the recipient bed that is thinned by lamellar dissection, could be safely performed in a short time, under good view of the lens.