Abstract
Purpose :
To evaluate the outcome of performing simultaneous Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) and Intraocular Lens (IOL) exchange surgery.
Methods :
A non-randomized retrospective chart review was conducted on 41 patients. The studied outcomes included status of the intraocular lens, status of the cornea transplant, as well as best corrected distance visual acuity (BCDVA), spherical equivalent (SEQ), and intraocular pressure (IOP) pre-operatively, as well as post-operative 1 day, 1 week, 1 month, 3 months, 6 months, 12 months, and 24 months.
Results :
41 patients, of which, 49% male, and 51% female were included. At the time of pre-operative assessment, 14 patients had an ACIOL implant (34.1%), 11 had a PCIOL implant (26.8%), 8 were aphakic (19.5%), with the 8 remaining patients (19.5%) having either a sulcus or capsular bag IOL implants.
Positioning of the IOL after exchange was 19 iris-sutured (46.3%), 9 scleral-fixated/sutured (22%), 4 ACIOL (9.8%), 4 PCIOL (9.8%), 3 sulcus placements (7.3%), and 2 in the capsular bag (4.9%).
At 1 year follow up, 57% of the patients’ corneal grafts were clear, 23% had corneal haze that did not require further surgery, while 23% had either corneal edema, or folds in the Descemet’s membrane and stroma, that were managed medically. At the same time period, only one eye had subluxation that necessitated an IOL repositioning surgery.
Mean IOP remained consistent during the follow up periods (14.25 ± 5.85 at baseline and 15.43 ± 7.99 at one year).
Mean BCDVA improved from 1.33 ± 0.66 at baseline to 0.82 ± 0.70 at two years follow up.
Conclusions :
Simultaneous DSAEK and IOL exchange surgery may offer a sustained improvement in visual acuity in patients with complex ocular history and may decrease the risk associated with increased trips to the operating room.
This is a 2021 ARVO Annual Meeting abstract.