Outcomes Following Combined DSAEK with Scleral-Glued IOL Placement

Abstract

Purpose : To evaluate the outcomes of Descemet’s stripping automated endothelial keratoplasty (DSAEK) performed concurrently with secondary scleral-glued intraocular lens (IOL) placement

Methods : A retrospective chart review of all cases of DSAEK combined with secondary scleral-glued IOL procedures from 2007 to 2015 by one cornea surgeon at the New York Eye and Ear Infirmary of Mount Sinai was conducted. The minimum post-operative follow-up time was 3 months. Eyes with prior secondary IOL placement were excluded. Post-operative outcomes included best-corrected visual acuity, IOL-related and other complications, incidence of re-bubbling or graft repositioning, incidence of transplant failure and rejection, and elevated intraocular pressure requiring treatment.

Results : Eighteen eyes of 18 patients were included, 44% (8/18) of whom were female. The average age was 76.7 ± 12.2 years. Mean follow-up time was 12.3 ± 8.0 months. Compared to preoperative visual acuity, stability or improvement was achieved in 89% (16/18) of our eyes. Fifty-six percent of eyes (10/18) developed post-operative intraocular pressure spikes greater than 21mmHg, 50% (9/18) requiring medical treatment. Thirty-three percent (6/18) required additional surgery,including 1 case of IOL repositioning, 1 case of retinal detachment repair, 1 case of PKP, 5 cases of rebubbling. Six percent (1/18) had primary graft failure, and 6% (1/18) developed graft rejection which was treated with topical corticosteroids.

Conclusions : This is the largest case series reporting clinical outcomes of combined DSAEK and secondary scleral-glued IOL placement. We found that the procedure is safe and effective with low rates of graft failure and excellent visual outcomes.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.