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Bozorgmehr Pouyeh, Leejee H. Suh, William J. Feuer, Sonia H. Yoo; Refractive stability and complications of combined phacoemulsification and Descemet Stripping Automated Endothelial Keratoplasty beyond 44 months. Invest. Ophthalmol. Vis. Sci. 2012;53(14):52.
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To evaluate complications and long-term refractive stability of combined phacoemulsification and Descemet Stripping Automated Endothelial Keratoplasty (phaco-DSAEK)
15 eyes of 12 patients matched our inclusion criteria. Follow-up was between 44 months and 59 months (median and mean=52 months). At the last visit, the best-corrected visual acuity (BCVA) was 20/25 or better in five (33%) eyes, and between 20/30 and 20/50 in eight (53%) eyes. BCVA of the last visit was not available for one eye. Overall, BCVA ranged from 20/60 to 20/20 (median=20/30). Compared to the first year, BCVA improved in 2 eyes and worsened in another 2 eyes (attributed to diabetes mellitus and posterior capsule opacity). Six (40%) eyes matched our definition of no change, four (27%) eyes underwent a myopic shift between +0.38 D and +1.25 D (median=+0.75 D) and five (33%) eyes underwent a hyperopic shift between -0.38 D and -2.38 D (Median= -0.75 D). Complications in our study population included ocular hypertension, graft rejection, posterior capsular opacification and corneal microcystic edema (related to ocular hypertension), which persisted after 30 months.
Following phaco-DSAEK, refraction may continue to change after one year which makes precise IOL calculation difficult in this procedure. The only documented complication after 30 months was persistent microcystic edema in one eye because of ocular hypertension.
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