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Anterior chamber versus posterior chamber intraocular lens in DMEK for pseudophakic bullous keratopathy

Poster Details

First Author: V.Liarakos GREECE

Co Author(s):    L. Ham   K. van Dijk   L. Baydoun   E. Livny   H. van Esch   G. Melles

Abstract Details



Purpose:

To evaluate the presence of an anterior chamber intraocular lens (AC-IOL) as a potential factor affecting the feasibility and outcome of Descemet membrane endothelial keratoplasty (DMEK) in eyes with pseudophakic bullous keratopathy (PBK).

Setting:

Netherlands Institute for Innovative Ocular Surgery

Methods:

DMEK was performed in 34 consecutive eyes diagnosed with PBK. In 7 eyes DMEK was performed in the presence of an iris-claw AC-IOL, whereas the remaining 27 eyes carried a PC-IOL. Endothelial cell density (ECD) decrease as well as intra- and post-operative complications were documented. Anterior chamber depth (ACD) measurements were particularly evaluated for the AC-IOL group.

Results:

DMEK was successfully completed without any significant intraoperative complications in all eyes, regardless of the type of the IOL. No AC-IOL was removed or exchanged. No significant difference in ECD decrease was observed between the two groups at 6 months (44 (±15) % in the AC-IOL group compared to 43 (±18) % in the PC-IOL group; P=0.91). In the AC-IOL group, central and mean peripheral ACD were measured to be 2.44 (±0.19) mm and 2.10 (±0.08) mm postoperatively (compared to 2.24(±0.31) mm and 1.78 (±0.20) mm preoperatively; P=0.40 and P=0.03 respectively). The most common postoperative complication was significant partial graft detachment, observed in one case with an AC-IOL and 5 cases with a PC-IOL (14% and 19%, respectively).

Conclusions:

The presence of a stable iris-claw AC-IOL did not affect ECD decrease or complications rate and was not considered a contra-indication in cases with PBK operated on with DMEK. FINANCIAL INTEREST: One of more of the authors... receives consulting fees, retainer, or contract payments from a competing company

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