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Phacoemulsification two years after central descemetorrhexis without corneal graft for Fuchs' endothelial dystrophy

Poster Details

First Author: R.Nosé USA

Co Author(s):    Y. Lu   R. Pineda II                 

Abstract Details

Purpose:

To report a case of a 60 year-old woman with Fuchs endothelial dystrophy who underwent phacoemulsification for moderate nuclear sclerosis two years after central Descemet membrane stripping without placement of a corneal graft.

Setting:

Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA

Methods:

A retrospective chart review and report of surgical outcome was performed. Preoperative pachymetry was 490 microns, and recent specular microscopy central endothelial cell count was 1471 cells/mm2. using the Nidek CEM-530 (Nidek Co., Japan). Phacoemulsification was carried out with the Alcon Centurion Vision System (Alcon, Fort Worth, Texas, USA), using a softshell technique with a divide and conquer nuclear disassembly. Standard coaxial irrigation and aspiration was performed. The AMO Tecnis ZCB00 (Abbott Medical Optics, Santa Ana, CA, USA) +23.0 diopter lens was placed in the capsular bag without complications.

Results:

Patient had mild central corneal edema which resolved by one week. Best corrected vision by 1 month was 20/20, and intended target refraction was accurate. Endothelial cell loss was less than 10% after one month.

Conclusions:

We report the first known case of phacoemulsification following central descemetorrexis without endothelial corneal transplantation for Fuchs endothelial dystrophy. Phacoemulsification resulted in a minimal affect on endothelial cell count, with only mild clinical postoperative corneal edema which resolved by one week with a good visual outcome. As novel strategies for endothelial disorders progress, understanding the impact of phacoemulsification on endothelial repopulation will be an important consideration.

Financial Disclosure:

NONE

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