Diffractive Intraocular Lens Implantation with cataract surgery following penetrating keratoplasty

Several reports have shown that penetrating keratoplasty (PKP) is a safe and effective technique for corneal transplant and provides good visual outcomes1-3. However, such as Rathi et al.4 reported in a retrospective study, the incidence for cataract formation is high. In this study 24.45% of patients developed cataract within the first years of surgery, being the excessive use of steroids the major risk factor for cataract formation after PKP. When post-PKP eyes develop cataracts, surgeons used to remove the cataract and to implant a monofocal intraocular lens (IOL). Nagra et al.5 and Hsiao et al.6 in retrospective studies showed that cataract extraction with monofocal IOL implantation after PKP is a safe and efficient procedure. However, these patients should wear spectacles or contact lenses for distance and/or near vision. Then, multifocal IOL implantation may be a better approach than a monofocal IOL implantation to provide simultaneous distance and near vision. To knowledge of the authors, there are not previous case reports of multifocal IOL implantation in eyes submitted to PKP. In this report, we described 3 PKP cases which have been submitted to cataract surgery with multifocal IOL implantation.