@article {1528431,
	title = {Survival of the fittest: phacoemulsification outcomes in four corneal transplants by Dr Ramon Castroviejo},
	journal = {Br J Ophthalmol},
	volume = {105},
	number = {8},
	year = {2021},
	month = {2021 Aug},
	pages = {1076-1081},
	abstract = {AIM: To evaluate and report the outcomes following phacoemulsification on four eyes, 45\&nbsp;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\&nbsp;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\&nbsp;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 {\textquoteright}mature{\textquoteright} 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.},
	issn = {1468-2079},
	doi = {10.1136/bjophthalmol-2020-316435},
	author = {Franco, Jovany Jeomar and Reyes Luis, Jose Luis and Rahim, Salma and Greenstein, Stephen and Pineda, Roberto}
}
