Combine and Conquer Combining sutureless lamellar keratoplasty, phacoemulsification, and IOL implantation in one surgery allows rapid visual rehabilitation in patients with cataract and corneal opacity Tushar Agarwal, Pooja Bandivadekar | 11/06/2015











At a Glance Phacoemulsification in patients with corneal opacity can be a challenge – patients with central but superficial opacity and concomitant cataract are common, yet do not typically require a full-thickness transplant

Conventional lamellar keratoplasty has issues, too – problems such as infection and suture-related astigmatism can make outcomes unpredictable

The use of biological glue to adhere the graft to the host cornea can bypass the problem of sutures, and has seen success when performed as a standalone procedure for treating corneal opacity

Combining cataract surgery with automated sutureless anterior lamellar keratoplasty can provide rapid vision rehabilitation, and make phacoemulsification more straightforward for the surgeon Performing phacoemulsification in a patient with corneal opacity is a challenge, even for an experienced cataract surgeon. Often, we come across patients with central but superficial opacities, and concomitant cataract, who do not warrant a full thickness keratoplasty. One option for these patients is a combined surgery, with a lamellar graft and phacoemulsification. However, conventional lamellar keratoplasty has its own problems, such as suture-related astigmatism and infections, and can be unpredictable.

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About the Authors

Tushar Agarwal

Tushar Agarwal is additional professor of Ophthalmology at the All India Institute of Medical Sciences, New Delhi, India. He gained national recognition for developing the technique of computer simulation-assisted rotational autokeratoplasty, receiving the Indian National Science Academy Young Scientist Medal, and a Best of Show award from the AAO. He has more than 60 published papers, and has developed over 15 new surgical techniques.

Pooja Bandivadekar

Pooja Bandivadekar is a Consultant Cornea, Cataract and Refractive Surgeon at the Doctor Eye Institute, Mumbai, India.