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Filed Under
Cornea
DMEK
endothelial keratoplasty
ACIOL
IOL exchange
combined surgery
2020 paper presentation
Purpose
To evaluate outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) combined with anterior chamber intraocular lens (ACIOL) exchange and transscleral fixation in patients with pseudophakic bullous keratopathy (PBK)
Methods
Patients who underwent DMEK combined with ACIOL removal and trans scleral IOL fixation at Toronto Western Hospital, Canada, between 2015 and 2018 was included in this study. Demographic characteristics, intra-operative and post-operative complications, best-corrected visual acuity (BCVA) and endothelial cell density (ECD) were analyzed.
Results
Thirteen eyes of 13 patients were included. Average age was 76.7 ± 12.7 years. BCVA prior to surgery and 6 months after surgery was 1.85 ± 0.96 logMAR and 0.47 ± 0.09 logMAR, respectively (p=0.02). Rebubble was performed in 4 eyes (32%). Two eyes (15%) developed hyphema. One eye (8%) was diagnosed with macular edema and one eye (8%) developed retinal detachment. Primary failure due to persistent hyphema was diagnosed in one eye (8%). Average ECD loss 6 months after surgery was 50% (p<0.05).
Conclusion
ACIOL replacement with a scleral-fixated IOL combined with DMEK is a viable option in cases of ACIOL and PBK. Associated complications were graft detachment, hyphema, macular edema and retinal detachment.
To evaluate outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) combined with anterior chamber intraocular lens (ACIOL) exchange and transscleral fixation in patients with pseudophakic bullous keratopathy (PBK)
Methods
Patients who underwent DMEK combined with ACIOL removal and trans scleral IOL fixation at Toronto Western Hospital, Canada, between 2015 and 2018 was included in this study. Demographic characteristics, intra-operative and post-operative complications, best-corrected visual acuity (BCVA) and endothelial cell density (ECD) were analyzed.
Results
Thirteen eyes of 13 patients were included. Average age was 76.7 ± 12.7 years. BCVA prior to surgery and 6 months after surgery was 1.85 ± 0.96 logMAR and 0.47 ± 0.09 logMAR, respectively (p=0.02). Rebubble was performed in 4 eyes (32%). Two eyes (15%) developed hyphema. One eye (8%) was diagnosed with macular edema and one eye (8%) developed retinal detachment. Primary failure due to persistent hyphema was diagnosed in one eye (8%). Average ECD loss 6 months after surgery was 50% (p<0.05).
Conclusion
ACIOL replacement with a scleral-fixated IOL combined with DMEK is a viable option in cases of ACIOL and PBK. Associated complications were graft detachment, hyphema, macular edema and retinal detachment.
View More Presentations from this Session
This presentation is from the session "SPS-101 Corneal Procedures & Diagnostics: EK, PK, CXL, Other" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.