PT  - JOURNAL ARTICLE
AU  - Franco, Jovany Jeomar
AU  - Reyes Luis, Jose Luis
AU  - Rahim, Salma
AU  - Greenstein, Stephen
AU  - Pineda, Roberto
TI  - Survival of the fittest: phacoemulsification outcomes in four corneal transplants by Dr Ramon Castroviejo
AID  - 10.1136/bjophthalmol-2020-316435
DP  - 2021 Aug 01
TA  - British Journal of Ophthalmology
PG  - 1076--1081
VI  - 105
IP  - 8
4099  - http://bjo.bmj.com/content/105/8/1076.short
4100  - http://bjo.bmj.com/content/105/8/1076.full
SO  - Br J Ophthalmol2021 Aug 01; 105
AB  - Aim To evaluate and report the outcomes following phacoemulsification on four eyes, 45 years or more after corneal transplantation.Methods A retrospective case series of four eyes in three patients (P1, P2, P3), undergoing phacoemulsification at least 45 years after corneal transplantation by Dr Ramon Castroviejo. Corneal graft survival outcome measures included central corneal thickness (CCT), best-corrected visual acuity (BCVA), corneal clarity and endothelial cell count (ECC).Results Phacoemulsification was successfully completed in all four cases with no instances of graft failure during the postoperative follow-up period, which ranged from 17 months to 76 months. At the conclusion of the follow-up period, all four grafts remained clear, and BCVA remained better than or similar to preoperative values. Long-term follow-up revealed no meaningful changes in CCT after phacoemulsification. All but one case experienced a decrease in ECC, with ECC values in the four cases ranging from 538 cells/mm2 to 1436 cells/mm2 at the conclusion of postoperative follow-up.Conclusion Limited data have been published on the long-term survival of corneal grafts after intraocular surgery, especially for extremely ‘mature’ corneal transplants. This case series demonstrates that with appropriate preoperative, intraoperative and postoperative measures, successful phacoemulsification can be performed in these cases with excellent long-term results.