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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


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).


Netherlands Institute for Innovative Ocular Surgery


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.


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).


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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