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Purpose <p>To evaluate the visual and refractive outcomes of cataract surgery in patients with previous deep anterior lamellar keratoplasty (DALK) or penetrating keratoplasty (PK) performed for keratoconus.</p> Methods <p>This cross-sectional study evaluated patients with a history of corneal transplantation who underwent cataract surgery. Corrected distance visual acuity (CDVA) and manifest refraction were assessed postoperatively. Pre- and postoperative outcomes were compared using paired t-tests and Wilcoxon signed-rank tests, while intergroup (PK vs. DALK) differences were analyzed using independent t-tests and Mann–Whitney U tests. Finally, multivariable linear regression analysis was performed to adjust for potential confounding variables.</p> Results <p>A total of 24 eyes from 24 keratoconus-affected patients were included, comprising 12 patients in each of the DALK and PK groups. Following cataract surgery, CDVA, spherical refractive error, and spherical equivalent (SE) showed significant improvement (p = 0.023, &lt; 0.001, and &lt; 0.001, respectively), while cylindrical refractive error remained unchanged (p = 0.943). Patients in the DALK group demonstrated better CDVA compared to those in the PK group (p = 0.028), a difference that remained significant after adjusting for confounders (p = 0.004). However, refractive outcomes, including spherical refractive error, cylindrical refractive error, and SE did not differ between the two groups (p = 0.127, 0.247 and 0.347, respectively). Graft survival was excellent in both groups at final follow-up.</p> Conclusion <p>Although the sample size is small, the results of this study show that cataract surgery yields favorable visual and refractive outcomes in post-keratoplasty patients, with superior results observed in DALK cases compared to PK.</p>

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Outcomes of cataract surgery in patients with previous corneal transplantation for keratoconus: comparison of PK and DALK

  • 期刊论文

  • 发表日期：

    2025年8月12日

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  • Kia Bayat,
  • Mohammad Ali Javadi,
  • Sepehr Feizi,
  • Ghazal Izadi-Jorshari,
  • Parisa Pooyan

摘要

Purpose

To evaluate the visual and refractive outcomes of cataract surgery in patients with previous deep anterior lamellar keratoplasty (DALK) or penetrating keratoplasty (PK) performed for keratoconus.

Methods

This cross-sectional study evaluated patients with a history of corneal transplantation who underwent cataract surgery. Corrected distance visual acuity (CDVA) and manifest refraction were assessed postoperatively. Pre- and postoperative outcomes were compared using paired t-tests and Wilcoxon signed-rank tests, while intergroup (PK vs. DALK) differences were analyzed using independent t-tests and Mann–Whitney U tests. Finally, multivariable linear regression analysis was performed to adjust for potential confounding variables.

Results

A total of 24 eyes from 24 keratoconus-affected patients were included, comprising 12 patients in each of the DALK and PK groups. Following cataract surgery, CDVA, spherical refractive error, and spherical equivalent (SE) showed significant improvement (p = 0.023, < 0.001, and < 0.001, respectively), while cylindrical refractive error remained unchanged (p = 0.943). Patients in the DALK group demonstrated better CDVA compared to those in the PK group (p = 0.028), a difference that remained significant after adjusting for confounders (p = 0.004). However, refractive outcomes, including spherical refractive error, cylindrical refractive error, and SE did not differ between the two groups (p = 0.127, 0.247 and 0.347, respectively). Graft survival was excellent in both groups at final follow-up.

Conclusion

Although the sample size is small, the results of this study show that cataract surgery yields favorable visual and refractive outcomes in post-keratoplasty patients, with superior results observed in DALK cases compared to PK.