الفهرس 
Title
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Abstract
Purpose: To compare the refractive and visual outcome of combined (triple) keratoplasty and cataract extraction with those of sequential surgery in keratoconus patients. Patients and methods: Retrospectively, keratoconus patients who underwent triple surgery or sequential surgery performed by the same surgeon, were reviewed. The triple procedure group consisted of 20 patients and the sequential group consisted of 20 patients. Both the preoperative and postoperative (one year follow up) refraction and visual acuity were collected and analyzed. Results: There was a statistical significant difference between the 2 groups, the mean postoperative refraction in the Sequential group was (0.80 /-2.79 x 65.53 SD = 2.76/1.66/36.89), and the mean postoperative refraction in the triple group was (3.42 /-1.80 x 76.58 SD = 3.62/2.56/46.58) (P value = 0.002 by Mann-whitney test). Conclusion: This analysis provided evidence that the sequential surgery has advantages over the triple surgery in terms of refractive and visual outcome