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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


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


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


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.


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.


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.

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