J Korean Ophthalmol Soc.  2016 Sep;57(9):1361-1368. 10.3341/jkos.2016.57.9.1361.

Clinical Outcomes of Combined Descemet-stripping Endothelial Keratoplasty and Intraocular Lens Exchange

• Kang DJ
• Kim HK

• KMID: 2351865
• DOI: http://doi.org/10.3341/jkos.2016.57.9.1361

Abstract

PURPOSE
To evaluate clinical outcomes after combined descemet-stripping endothelial keratoplasty (DSEK) and intraocular lens (IOL) exchange in a Korean population.
METHODS
The medical records of 15 patients (15 eyes) with pseudophakic bullous keratopathy who underwent combined DSEK and IOL exchange from January 2011 to January 2015 and who were followed up for more than 12 months were reviewed retrospectively.
RESULTS
In 14 eyes with successful results after surgery, the best corrective visual acuity (BCVA) was significantly improved from 2.01 ± 0.96 (log MAR, mean) to 0.68 ± 0.26 at 3 months (p = 0.001) except for one eye that received reoperation on the endothelial disc detachment. The BCVA at postoperative 6 and 12 months gradually increased (0.51 ± 0.26 and 0.40 ± 0.22 log MAR, mean). Central corneal thickness was significantly improved from 777 ± 139 µm to 605 ± 28 µm at 6 months (p = 0.003) and was maintained at 12 months. The mean endothelial cell count was 2,973 ± 281/mm2 in the donor lenticules and 1,790 ± 265/mm2 at 12 months. Endothelial cell loss was 40%. The target refraction was -0.81 ± 0.16 D and the 12 months postoperative spherical equivalent was -0.28 ± 0.36 D. Complications included intraocular pressure elevation in one eye and pupillary capture in one eye.
CONCLUSIONS
Combined DSEK and IOL exchange may be a very efficient and safe option for surgically managing pseudophakic bullous keratopathy.

Keyword

Descemet-stripping endothelial keratoplasty (DSEK); Intraocular lens (IOL) exchange; Pseudophakic bullous keratopathy; Scleral fixation

MeSH Terms

Corneal Transplantation*
Endothelial Cells
Humans
Intraocular Pressure
Lenses, Intraocular*
Medical Records
Reoperation
Retrospective Studies
Tissue Donors
Visual Acuity

Figure

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  Figure 1. Changes in best corrected visual acuity (BCVA) after combined descemet-stripping endothelial keratoplasty and intraocular lens exchange. The BCVA improved at post-operative 3 months. * Wilcoxon signed rank test.

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  Figure 2. Changes in central corneal thickness (CCT) after combined descemet-stripping endothelial keratoplasty and intraocular lens exchange. * Wilcoxon signed rank test.

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  Figure 3. Changes in endothelial cell count (ECC) after combined descemet-stripping endothelial keratoplasty and intraocular lens exchange. * Wilcoxon signed rank test.

Reference

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