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Descemet's membrane endothelial keratoplasty after multifocal intraocular lens implantation

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Session Details

Session Title: Presented Poster Session: Cataract Surgery Complications and Management III

Session Date/Time: Sunday 06/09/2015 | 09:30-11:00

Paper Time: 10:10

Venue: Poster Village: Pod 1

First Author: : N.Cesario Pereira BRAZIL

Co Author(s): :    E. Diniz   R. Ghanem   R. Cunha Filho   T. Prazeres   O. Nunes   A. dos Santos Forseto

Abstract Details

Purpose:

To describe the results of Descemet Membrane Endothelial Keratoplasty (DMEK) performed in patients with endothelial dysfunction after multifocal intraocular lens implantation (IOL).

Setting:

The study was carried out at Sorocaba Eye Bank. The surgeries were performed in Sorocaba, Salvador, Joinvile and Cuiabá, Brazil.

Methods:

Retrospective review of nine patients (n=9 eyes) that developed endothelium dysfunction after cataract surgery with multifocal IOL implantation, and were managed with DMEK. Causes of endothelial failure were: Descemet membrane detachment (n=2), toxic anterior segment syndrome (n=1), traumatic surgery with posterior capsule rupture, vitreous loss and IOL scleral fixation (n=1), Fuchs Endothelial Distrophy (n=3) and unknown (n=2). Clinical results were described.

Results:

Early postoperative partial graft detachment occurred in 2 eyes, requiring one re-bubble each. No other complication was noted. At one month after surgery no cornea edema was observed, and 7 patients had best-corrected distance visual acuity (BCDVA) of 20/30 or better. Two eyes required YAG laser capsulotomy for posterior capsule opacification. Excluding one patient with macular edema, all patients had BCDVA of 20/30 or better and best corrected near visual acuity of J1 or better. Two patients underwent Excimer Laser ablation for residual refractive error, 3 and 7 months after DMEK. One month after laser surgery, those two patients had uncorrected visual acuity (UCVA) of 20/20 and 20/25 for far and J1 for near.

Conclusions:

Endothelium dysfunction in patients with multifocal IOL can be safely managed with DMEK, yielding good visual outcomes and fast visual recovery. Posterior capsule opacification and residual refractive errors may limit the outcomes, but can be solved with Yag laser capsulotomy or Excimer Laser refractive surgery respectively.

Financial Interest:

NONE

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