| Patients, who suffered from corneal leucoma which were secondary to corneal ulceration and perforation caused by some etiological factors, such as trauma, infection, combined with cataract, demand treatmental penetrating keratoplasty as well as extraction of the opaque lens, and finally acquire the optical function of the anterior fragment. Once the surgical method we have taken is to have penetrating keratoplasty on the first stage,then to have cataract extraction with transparent cornea graft on the second stage and restore vision. Nowadays doctors and patients both promise a better surgery, which is less damage, more reliable effect, less short treatment process. We have performed partial penetrating keratoplasty combined with cataract extraction on 36 cases from 2000 to 2005 April. Including of keratoconus, infection, perforating wounds, thermal burns, acid and alkaline chemical injury which caused corneal leucoma combined with cataract. At the same time we choose randomly 45 cases of simple PKP as controls. The section include 36 consecutive eyes, 22 male's,14 female's; mean aged 36 years old and ranged 77 to 18 years old; mean history is 127 months ranged from 4 to 492 months. Corneal leucoma by infection, complicated cataract 8 eyes, corneal leucoma combined with cataract by perforating wounds 18 eyes, corneal leucoma combined with cataract by thermal burn and chemical injury 9 eyes, corneal leucoma by acute keratoconus combined with congenital cataract 1 eye, altogether 36 eyes. Ophthamology check before the operation:vision:LP:12 eyes,33.3%;HM:12 eyes,33.3%;CF:4 eyes,11.1%;0.01~0.05:8 eyes,22.2%。Red and green color perceision were abnormal. Corneal leucoma field limit to the center and diameter ranged from 5.5mm~7mm. There were not retinal detachment and PVR with B supersonic examination. The donor eyes comes the youth,and were excised and preserved in the wet house within 1 hour,and were used within 4-8 hours. All the donors excluded infectious diseases, malnutrition and malignancy, and corneal diseases and other anterior fragment deseases by slit-lamp biomicroscope. Intraocular-lens powercalculation based on SRK2 according to the healthy eye. All of cases took partial penetrating keratoplasty combind cataract extraction, and except that one had triple procedure (combined cataract extraction + IOL + PK)and at the end of the operation was implanted one posterior chamber intraocular lens. We have statistical analysis to find out that there are no significantly difference between the combind surgery and simple PKP. The visual acuity of 36 cases were all improved; 26 cases got a corrected visual acuity of above 0.05,and the rate out of blindness was 72.2%. Corneal graft: Besides 2 cases due to secondary glaucoma had temporary edema and opaque, the wound of all cases were tightly closed and the grafts were transparent until patients left hospital. That 2 cases were diagnosed as secondary glaucoma on the day 8,11 after the surgery, after trabeculotomy the IOPs were decreased to the normal range, all the cases had no immunoreaction and intraocular infection until patients left hospital. We can draw a conclusion that combined surgery should be performed by a excellent operator, and compared with simple...
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