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Posterior iris-claw aphakic intraocular lens implantation and Descemet's membrane endothelial keratoplasty

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Session Details

Session Title: Cataract Surgery Special Cases I

Session Date/Time: Sunday 14/09/2014 | 14:30-16:30

Paper Time: 15:26

Venue: Boulevard G

First Author: : J.Gonnermann GERMANY

Co Author(s): :    A. Maier   M. Klamann   T. Brockmann   E. Bertelmann   A. M. Joussen   N. Torun

Abstract Details


To evaluate clinical outcomes and complications after Descemet membrane endothelial keratoplasty (DMEK) and posterior iris-claw aphakic intraocular lens (IOL) implantation.


Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Germany


This prospective cohort study comprised 7 consecutive eyes (7 patients) without adequate capsular support and bullous keratopathy undergoing posterior iris-claw aphakic IOL implantation and DMEK. Corneal transparency, central corneal thickness (CCT), endothelial cell density (ECD), visual outcomes, and complication rates were measured during the follow-up.


The iris-claw IOLs were inserted during an IOL exchange in 3 eyes, and as a secondary IOL implantation in 1 aphakic eye during DMEK procedure. Three eyes had IOL exchange prior to secondary DMEK. Mean follow-up was 7 months (range from 3 to 14 months). The final best-spectacle corrected visual acuity (BSCVA) improved significantly (0.33 ± 0.31 logMAR) compared to the preoperative BSCVA (1.84 ± 0.90 logMAR). The mean endothelial cell loss was 24.8% over the follow-up. Complications included graft dislocation in 4 eyes; which could be easily reattached with rebubbling procedure. No graft failures, no cases of pupillary block glaucoma and no IOL dislocations were encountered.


DMEK and retropupillar iris-claw IOL implantation provide good visual outcomes with a fast visual recovery and appear to be a feasible method for the management of bullous keratopathy but with higher graft detachment rates.

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