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Presentation type	E-poster
Title	Post-traumatic Anterior Segment Reconstruction: First Results of Combined Penetrating Keratoplasty (PKP) – Carlevale IOL – Artificial Iris (AI) Implantation.

Purpose	To present the functional and aesthetic outcomes of surgical reconstruction of the anterior segment in three patients.
Methods	Three male patients (aged 23, 52 and 71y) with a history of post-traumatic corneal scarring, partial or complete aniridia and aphakia underwent a combined PKP, scleral-fixated Carlevale IOL and artificial iris (AI) implantation. Preoperatively, all patients experienced poor aesthetics, limited visual acuity (BCVA ranging from hand movements to counting fingers) and photophobia. All patients underwent pars plana vitrectomy before combined PKP-Carlevale-AI surgery.
Results	Surgery was performed using a stepwise approach, including Flieringa ring fixation, creation of lamellar scleral pockets, suturing of the AI to the anterior surface of the Carlevale IOL and use of a “rescue suture” to prevent posterior tilting of the Carlevale-AI complex after docking of the first haptic (video). No complications were encountered during surgery. All patients had a favorable postoperative course with good aesthetic results and improved visual acuity (case 1: BCVA 0.15 at 4 months, case 2: 0.1 at 9 months and case 3: 0.9 at 22 months postoperatively). There was no evidence of rejection or persistent inflammation during follow-up. However, one patient (case 3) developed persistently elevated intraocular pressure requiring a Paul Glaucoma Implant.
Conclusion	This case series demonstrates excellent functional and aesthetic outcomes following surgical reconstruction of the anterior segment after combined PKP, Carlevale IOL and AI implantation.
Conflict of interest	No

Authors 1

Last name	HOEBEKE
Initials	L
Department	1* Dept of Ophthalmology, Ghent University Hospital, Ghent, Belgium
City	Ghent

Authors 2

Last name	ACCOU
Initials	G
Department	1*
City	Ghent

Authors 3

Last name	NERINCKX
Initials	F
Department	1*
City	Ghent

Authors 4

Last name	VAN HOORDE
Initials	T
Department	1*
City	Ghent

Authors 5

Last name	DERVEAUX
Initials	T
Department	1*
City	Ghent

Authors 6

Last name	ROELS
Initials	D
Department	1*
City	Ghent