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Endothelial keratoplasty in eyes with an angle-supported anterior chamber intraocular lens

Poster Details

First Author: S.Souki GREECE

Co Author(s):    A. Lazaridis   A. Mouchtouris   A. Thoma   K. Chatzistefanou   C. Koutsandrea   K. Droutsas     

Abstract Details

Purpose:

Aim of the present study is to analyze the outcomes of endothelial keratoplasty (EK) in the presence of an angle-supported intraocular lens (IOL).

Setting:

Cornea Department of the Athens University Eye Clinic, Athens, Greece

Methods:

Twelve consecutive EK procedures (6 Descemet membrane endothelial keratoplasty (DMEK) and 6 Descemet stripping automated endothelial keratoplasty (DSAEK)) of eyes with corneal endothelial decompensation in the presence of an angle-supported IOL and a minimum follow-up of 6 months were included. Corrected distance visual acuity (CDVA), biomicroscopy, tonometry, and endothelial microscopy were performed preoperatively and at 6 months after surgery. Intraoperative and postoperative complications were recorded.

Results:

Twelve eyes of 2 women and 10 men undergoing EK (DMEK, n=6 and DSAEK, n=6), were included. Concomitant eye conditions included a history of traumatic cataract extraction in 4 cases and pars-plana vitrectomy for penetrating ocular injury in 2 cases. Pre-existing glaucoma was present in 2 cases and amblyopia in one case. One cornea with a superficial scar after microbial keratitis was included. Preoperative CDVA was counting fingers or less in all cases. At 6 months, half of the eyes had a CDVA >0.05 and CDVA ranged between hand movement and 0.5 in the total group. Postoperatively, significant macular pathology was observed in 3 cases. Graft failure after graft detachment, immunologic rejection and infectious endophthalmitis occurred in one case respectively.

Conclusions:

Our results suggest that EK in the presence of an angle-supported IOL, that is, in the absence of an iris-lens diaphragm, is feasible. Notably, all eyes included in the present study were legally blind prior to EK. Thus, although both pre-existing pathology and postoperative complications may have limited the visual outcome in our series, a rise of visual acuity over the threshold of legal blindness could be achieved in half of the cases undergoing EK.

Financial Disclosure:

NONE

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