September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Staged or Combined Descemet Stripping Automated Endothelial Keratoplasty Surgery and Cataract Extraction/Intraocular Lens Implant
Author Affiliations & Notes
  • Lily Van Laere
    Ophthalmology, William Beaumont Hospital, Ferndale, Michigan, United States
  • Nirupa cuttler
    Ophthalmology, William Beaumont Hospital, Ferndale, Michigan, United States
  • Alan Spigelman
    Ophthalmology, William Beaumont Hospital, Ferndale, Michigan, United States
  • Footnotes
    Commercial Relationships   Lily Van Laere, None; Nirupa cuttler, None; Alan Spigelman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1219. doi:
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      Lily Van Laere, Nirupa cuttler, Alan Spigelman; Staged or Combined Descemet Stripping Automated Endothelial Keratoplasty Surgery and Cataract Extraction/Intraocular Lens Implant. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1219.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Many patients with Fuchs endothelial dystrophy require both Descemet stripping automated endothelial keratoplasty (DSAEK) and cataract extraction with intraocular lens implant (CE/IOL). However, controversy exists regarding the timing of these procedures. We performed a retrospective, observational clinical study to evaluate visual outcomes and complication rates after surgery in patients who received both staged and combined DSAEK and CE/IOL.

Methods : We conducted a retrospective chart review of 85 eyes in 58 patients who received staged or combined DSAEK and CE/IOL at our practice between 2006 and 2014. All procedures were conducted in the same surgical center by a single surgeon, and exclusion criteria included inadequate follow up and presence of co-morbidities or prior surgeries. We collected the following data points: age, gender, time between DSAEK and CE/IOL, best spectacle-corrected visual acuity (BSCVA) pre surgery and at various points post surgery, and any surgical complications.

Results : The eyes were divided in to two groups, staged DSAEK followed by CE/IOL or combined DSAEK/CE/IOL. 85 eyes were included in the study, 33 had staged procedures and 52 had combined procedures. In the staged group, the mean time between DSAEK and CE/IOL was 36 days. Baseline demographics were similar in all groups, and all groups experienced a significant improvement in BSCVA, 0.26 logMAR in the staged group and 0.18 logMAR in the combined group. No patients in either group had primary graft failure. There were 4 cases of graft dislocation in the combined group, which resolved with medical/surgical management. There were no significant differences in groups with respect to change in BSCVA, time to reach final BSCVA, or complication rates.

Conclusions : Descemet stripping automated endothelial keratoplasty (DSAEK) and cataract extraction with intraocular lens implant (CE/IOL) are safe and effective procedures that significantly improve BSCVA in patients with endothelial corneal dystrophy. DSAEK and CE/IOL may be done in a staged or combined manner, with no significant difference with repect to change in BSCVA, time to reach final BSCVA, or complication rates.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Staged or Combined DSAEK and CE/IOL: Demographics, Visual Outcomes, and Complication Rates

Staged or Combined DSAEK and CE/IOL: Demographics, Visual Outcomes, and Complication Rates

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