In cataract surgery following penetrating keratoplasty, do you think the use of scleral tunnel incisions versus clear corneal incisions meaningfully influence graft survival or astigmatic stability?

I generally prefer a clear corneal incision for most cataract surgeries following PK. Regarding endothelial safety, there are limited studies directly comparing endothelial cell loss or corneal edema between incision types. In my own experience over the past year, I have not encountered endothelial ...

With a PK or DSEK, I do what I can to stay out of the cornea... scleral tunnel.

I have less experience with cataract surgery in the setting of a prior PK, but in those I have done, I have always made a CCI with the intention to stay away from the host-graft interface, and this has served me well. I have not had a graft decompensate, and there have been no surprises. Albeit my n...