Cataract surgery combined with ocular surface reconstruction in patients with severe cicatricial keratoconjunctivitis

Purpose: To present the technique and outcome of cataract surgery combined with ocular surface reconstruction in patients with severe cicatricial keratoconjunctivitis. Setting: Department of Ophthalmology, Tokyo Dental College, Chiba, Japan. Methods: Phacoemulsification with transplantation of a limbal allograft and an amniotic membrane was performed in 4 eyes of 3 patients with cataract and end-stage cicatricial keratoconjunctivitis. The surgical technique and the improvements in visual acuity were reviewed. The follow-up ranged from 13 to 27 months. Results: Phacoemulsification and intraocular lens implantation were performed in all cases without intraoperative complications. In 3 of the 4 eyes, the best corrected visual acuity improved from hand motions to 20/100, hand motions to 20/30, and counting fingers to 20/50. The visual acuity recovered to 20/60 postoperatively in 1 eye in which the preoperative visual acuity was light perception; at 1 year, the visual acuity decreased to hand motions because of recurrent fibrous tissue over the cornea. Conclusion: Small-incision phacoemulsification was performed safely in combination with ocular surface reconstruction in patients with cataract and end-stage cicatricial keratoconjunctivitis.