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To remove or not to remove (the AC-IOL)? This is the question

Poster Details

First Author: M.Tsatsos GREECE

Co Author(s):    I. Athanasiadis   N. Ziakas                 

Abstract Details


To Assess endothelial graft survival in cases of retained stable AC-IOLs and compare it with endothelial graft survival in cases of combined AC IOL removal, exchange with a PC glued IOL and Endothelial grafting


Southampton University Hospital Aristotle University of Thessaloniki Dorset County Hospital


We retrospectively reviewed our DSEK, DMEK and PDEK cases associated with the presence of an AC-IOL over a period of 18 months


there were four eyes undergoing DSEK with a retained AC-IOL (stable but with variable anterior chamber depths) as well as three DSEK and PDEK cases combined with removal of the AC-IOL and posterior placement of a PC-IOL through scleral flaps with and without iridoplasty. In the retained AC-IOL DSEK patients, there was a 25% secondary failure (one in four cases which was associated with shallow AC) over a period of 18 months, whereas in the AC-IOL exchange and replacement with PC-IOL group no secondary failures were noted over the same period for both two PDEK and one DSEK cases.


Although AC-IOL exchange and PC-IOL scleral fixation combined with DS(A)EK/DMEK or PDEK is a lot more labour-intensive in comparison with endothelial keratoplasty in retained AC-IOL, it may still be a more viable option in terms of graft survival.

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