Lens opacities after nonmechanical versus mechanical corneal trephination for keratoplasty in keratoconus

Ashley Behrens, Berthold Seitz, Achim Langenbucher, Murat M. Kus, Michael Küchle, Gottfried O.H. Naumann

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Purpose: To compare the lens opacity formation after penetrating keratoplasty (PKP) using nonmechanical excimer laser corneal trephination and mechanical motor trephination. Setting: University Eye Clinic, University of Erlangen-Nunberg, Erlangen, Germany. Methods: Ninety-six patients with keratoconus (96 eyes) and clear crystalline lenses were randomiy assigned to the nonmechanical trephination (NMT) group (n = 46; 35 men; mean age 38.2 years ± 10.8 [SD]) or the mechanical trephination (MT) group (n = 50; 35 men; mean age 34.4 ± 9.0 years). Suturing and postoperative treatment were identical. Dilated pupil biomicroscopy and slitlamp lens photography were performed preoperatively and postoperatively at 3 month intervals. Opacities were identified as cortical, nuclear, and posterior subcapsular and graded from 1 (mild) to 3 (severe). Results: Mean follow-up in the NMT/MT group was 3.2 ± 1.3 years/3.4 ± 1.1 years. Overall, incident opacities appeared in 23.9%/32.0% of eyes (4.3%/6.0% cortical; 19.6%/26.0% posterior subcapsular; 0%/0% nuclear) (P = .833). All cortical opacities in both groups were grade 1; posterior subcapsular opacities were grade 1 in 66.6%/61.5% of eyes and grade 2 in 22.2%/30.8% of eyes. One patient in each group presented grade 3 posterior subcapsular opacities. No differences between trephination methods were seen in a 5 year Kaplan-Meier cumulative 2risk of lens opacity formation (P = .763 cortical, P = .530 posterior subcapsular). Conclusion: In addition to its optical advantages, nonmechanical corneal trephination appears to have no adverse impact on cataract formation after PKP for keratoconus. (C) 2000 ASCRS and ESCRS.

Original languageEnglish (US)
Pages (from-to)1605-1611
Number of pages7
JournalJournal of cataract and refractive surgery
Issue number11
StatePublished - 2000
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology
  • Sensory Systems


Dive into the research topics of 'Lens opacities after nonmechanical versus mechanical corneal trephination for keratoplasty in keratoconus'. Together they form a unique fingerprint.

Cite this